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Indira Global Business School

This document is an enrollment form for the second year of an MBA program at Indira Global Business School for the academic year 2020-2021. It contains details such as the student's personal information, contact details, date of birth, category, parents' names and contact numbers, as well as a declaration signed by the student agreeing to pay any difference in fees that may be announced. It also includes the student's payment details for the fees, with a transaction reference number for a deposit made on July 18, 2020.

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Mohd Faizal
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137 views3 pages

Indira Global Business School

This document is an enrollment form for the second year of an MBA program at Indira Global Business School for the academic year 2020-2021. It contains details such as the student's personal information, contact details, date of birth, category, parents' names and contact numbers, as well as a declaration signed by the student agreeing to pay any difference in fees that may be announced. It also includes the student's payment details for the fees, with a transaction reference number for a deposit made on July 18, 2020.

Uploaded by

Mohd Faizal
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Sr. No.

SHREE CHANAKYA EDUCATION SOCIETY’S

INDIRA GLOBAL BUSINESS SCHOOL


PARANDWADI, TAL- MAWAL, DIST- PUNE- 410 506.
APPROVED BY AICTE, NEW DELHI AND AFFILIATED TO SAVITRIBAI PHULE PUNE UNIVERSITY

M.B.A - SECOND YEAR ENROLLMENT FORM


A.Y. 2020-21
_____________________________________________________________________________________________________
_
www.indiragbs.edu.in Email- admin@indiragbs.edu.in

PRN : 2051911188 Aadhaar No.: 407462393155

Specialization : MARKETING Bank A/C No.: 158542017798


Admitted in FY Through : MANAGEMENT PAN No. : ADAPF6214G
Candidature :. M.S. O.M.S. Voter ID No.: NILL

1. Full Name : __MD __________FAIZAL___________________________________________________________________________________________ (In


Capital) (Surname/ आडनाव) (First Name/ऩाव) (Middle Name/ वडडलाााांचे\पतीचे नाव)

2. Permanent : _332/6 CHAKIA


ALLAHABAD__________________________________________________________________________________
Address ________________________________________________________________________________________________________
(कायमचा पता) ________________________________________________________________________________________________________

3. Correspondence : _YOUR SPACE


WAKAD_______________________________________________________________________________________________________ Address
________________________________________________________________________________________________________
• (सााांपकाचा पता)
___________________________________________________________________________________________________________________________________Pe
rsonal Email __faizal0098@gmail.com_________________________________________

• Phone No.(दरध़वनीू ) : _______________________________________ Mobile (माााा॓बाईल नााां) :

_8542017798_________________________________________ (With STD Code)

4. Date of Birth : __04_____/___11______/_____1995____________ Nationality


:___INDIAN_______________________________________________
(जऩमददनाााांक) (DD/MM/YYYY)
5. Category :
 OPEN OBC SC ST DT/NT VJ
SBC

6. Full Name of Father: __MOHD RIZWAN___________________________________________________ Mob No. (माााा॓बाईल नााां):


__9450632797__________________________

7. Full Name of Mother: _NAGMA RIZWAN____________________________________________________ Mob No. (माााा॓बाईल नााां)


___9795801583_________________________

8. Full Name of Local: ___MANAS PRADHAN__________________________________________________ Mob No. ( माााा॓बाईल नााां)


__8087112026__________________________ Guardian (If any)

DECLARATION TO BE SIGNED BY THE CANDIDATE

As per guidelines, I, __MD FAIZAL________________________________________ completely aware about the rules and regulations
laid down by the institute. I understand, to confirm in Second Year MBA, I should clear the fee which is subject to
change as per guidelines of Fees Regulating Authority, Govt. of Maharashtra.
I hereby give my consent to pay the difference if any, in the fees as & when to be announced by Fees Regulating
Authority.

Date:__18/07/2020______________________________

Place: _ PUNE_____________________________
_______________________________________________
(Signature of the Candidate)

• Payment Details:

Bank Name: INDUSIND BANK

Account Number: 158542017798

Name of Account Holder: MOHD FAIZAL

Transaction ID: Ref no. 20015682268

Date: 18/07/2020

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