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ApplicationForm 1

This document is an application form for the Institute of Psycho Management Studies, requiring personal and educational details from the applicant. It includes sections for contact information, educational qualifications, and a declaration of adherence to the institute's rules. Additionally, it outlines the necessary documents to be enclosed and provides a section for office use regarding fee details.

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jkc college
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31 views1 page

ApplicationForm 1

This document is an application form for the Institute of Psycho Management Studies, requiring personal and educational details from the applicant. It includes sections for contact information, educational qualifications, and a declaration of adherence to the institute's rules. Additionally, it outlines the necessary documents to be enclosed and provides a section for office use regarding fee details.

Uploaded by

jkc college
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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INSTITUTE OF PSYCHO MANAGEMENTSTUDIES

174, Madhura Aptts, RPTS Road, Laxmi Nagar, Nagpur – 440022, TEL.: 0712-2229487 / 9890253717

APPLICATION FORM
Course Applied for: ____________________________________________
Medium: _____________________________________________________
Full Name: ___________________________________________________
PHOTO
Complete Address: _____________________________________________
_____________________________________________________________
_____________________________________________________________
Tel. No. (Resi.) ______________________ (Office.) ____________________________
Mobile No.: _______________________ Email id: ______________________________
Date of Birth: _______________ Gender: __________ Marital Status: ______________
Name of Father : _________________________________________________________
Name of Mother : ________________________________________________________
AADHAR No. : ________________________PAN No.__________________________
Educational Qualification:
S.No. Name of Degree University Year of Passing Class Obtained

Documents Enclosed (duly attested)


1. Age Proof :_________________________,______________________________
2. Qualification Certificate:______________________,______________________
3. Photographs:______________________________________________________
4. Remittance - Cash/DD/Cheque No.___________ /Bank Transfer_____________
5. Any Other________________________________________________________
Declaration::
I will abide by the rules and regulations of the institute and apply myself seriously to the studies.
Place:
Date: Signature of the Applicant

FOR OFFICE USE ONLY


Folio No. ________________________ Enrolment No. __________________________
FEE DETAILS
Paid Rs. _____________ By Cash/ Cheque/ DD No. _______________ Dated ________
ON Bank _____________________________ R.No. _______________ Dated ________

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