RAMAIAH INSTITUTE OF MANAGEMENT STUDIES (RIMS)

(An institution under M S Ramaiah Foundation)

New BEL Road, MSRIT Post, M S Ramaiah Nagar, Bangalore 560054, India
Phone: 91-80-2360 7640 / 7641 / 7579
Fax: 91-80-2360 7642
E-mail: admissions@rimsbangalore.in
Website: www.rimsbangalore.in

RI MS
Ramaiah Institute of Management Studies
Evolving Leaders

APPLICATION FORM FOR 2012 2014 BATCH

Application Number:

(for office use only)

Please read the instructions on Page 4 before proceeding to fill up the form
Applying for: (you may choose more than one program)

PGPM* + MBA (UoM1)

PGPM

MBA (SBS2)

MBA (UoM)

PGDM (AIMA3)

MBA (AU4)

Please affix your recent

passport size
photograph here

Post Graduate Program in Management; University of Mysore;

3
4
SBS Swiss Business School; All India Management Association; Annamalai University

1. Full Name: .............................................................................................................................................

th

(as per your 10 Standard Marks Card)

2. Do you want a hard copy of the prospectus?

3. Date of Birth:
4. Gender:
5. Nationality:

Male
Indian

Yes

No

Female
NRI

Foreign National

6. Contact Address: ..................................................................................................................................

...............................................................................................................................................................
...................................................................................................PIN: ....................................................
City: ......................................... State: ............................................ Country: ......................................
7. Phone Number - Residential (with STD code): ............................................................................................
Alternate Phone Number (with STD code): ..................................................................................................
8. Mobile Number: .....................................................................................................................................
9. Primary E-mail Address: .......................................................................................................................
Alternate E-mail Address: .....................................................................................................................

10. Educational Qualifications:

Level

Name of the
Degree

Name and Place of

the Institution

Name and Place

of the
Board/University

Years Studied
From

To

Aggregate
Percentage of
all the
years/semesters

th

10 Standard

th

12 Standard

Graduation

Post
Graduation
(if any)

Professional
Qualifications
(if any)
Note: Final year Graduate/Post Graduate students should also fill up the last column with the most recent data.

11. Aptitude Test Score:

Aptitude Test

CAT
GMAT
XAT
MAT
ATMA
JC CAT
OTHER
(specify)

Register Number

Date of Test

Composite Score

Percentile

12. Post Education Work Experience, if any (in reverse chronological order):

Name of the
Company

Address of
the
Company

Designation

Roles and Responsibilities

(in not more than 3 bullet
points)

Duration
From

To

Number of
Months

13. Awards and Recognitions, if any:

...............................................................................................................................................................
...............................................................................................................................................................
...............................................................................................................................................................
...............................................................................................................................................................
...............................................................................................................................................................
14. Additional Information:
a. Fathers Name: ...............................................................................................................................
b. Mothers Name: ...............................................................................................................................
c. Local Guardians Name (if applicable): ...........................................................................................
d. Fathers/Mothers/Guardians Occupation:
Service

Own Business

Professional

Other (specify) ...............................

Designation: ....................................................................................................................................
Organization: ...................................................................................................................................
Telephone No. Residential

(with STD code):

......................................................................................

Office (with STD code): ..................................................... Mobile: .......................................................

E-mail Address: ...............................................................................................................................

DECLARATION
15. I hereby declare that the details given above are accurate to the best of my knowledge. In the event
of any information being found false or incorrect, my admission would stand cancelled without any
further notice.
Date (DD/MM/YYYY): ...........................................................................................................................
Place: ....................................................................................................................................................

Signature of the Applicant

IMPORTANT INSTRUCTIONS
1. There is no Application Fee.
2. Please visit www.rimsbangalore.in for Eligibility and Process.
3. Things to be enclosed with the Application Form:
a. Photocopy of your Aptitude Test Admit Card (if you are awaiting results/yet to appear) /
Photocopy of your Aptitude Test Score Card (if the results have been declared).
b. A demand Draft of INR 650 drawn in favour of Ramaiah Institute of Management
Studies, payable at Bangalore (only if you want a hard copy of the prospectus).
4. All fields are mandatory. Incomplete Application Forms will be rejected.
5. There is no need to enclose photocopies of your marks cards or other documents. You will
need to produce these only if you are shortlisted to participate in our admission process.
6. Please send the completed Application Form along with the enclosures to:
The Admissions Office
Ramaiah Institute of Management Studies (RIMS)
New BEL Road, MSRIT Post, M S Ramaiah Nagar
Bangalore 560054, India