FISAT BUSINESS SCHOOL
FEDERAL INSTITUTE OF SCIENCE AND TECHNOLOGY (FISAT)
(An ISO 9001 : 2000 certified Institution managed by the Federal Bank Officers Association Educational Society)
Focus on Excellence
HORMIS NAGAR, MOOKKANNOOR P O-683 577, ERNAKULAM DISTRICT, KERALA, INDIA. (Approved by AICTE - Affiliated to Mahatma Gandhi University, Kottayam)
Tel: (O) 0484 - 2616267, 2616406 E-mail: mail@[Link] Website: [Link]
APPLICATION FOR ADMISSION TO MASTER OF BUSINESS ADMINISTRATION
(Fill in BLOCK LETTERS or tick wherever applicable)
Application No.
Year of Admission: 2010
PERSONAL DETAILS
01. NAME (as entered in the SSLC/10th Std) DATE OF BIRTH RELIGION & COMMUNITY CATEGORY SC ST OEC OBC OTHERS 03. SEX M F
02. 04. 05.
PHOTO
06.
FATHERS NAME, OCCUPATION & OFFICIAL ADDRESS IF ANY, WITH PHONE NUMBER (Mention whether a
member of FBOA Educational Society)
07.
MOTHERS NAME, OCCUPATION & OFFICIAL ADDRESS IF ANY, WITH PHONE NUMBER (Mention
whether a member of FBOA Educational Society)
08.
PERMANENT ADDRESS WITH PINCODE
ADDRESS FOR COMMUNICATION WITH PINCODE
Phone No. with STD Code
Phone No. with STD Code
DETAILS OF MAT SCORE
09. Composite Score MAT MAT Percentile Month & Year of MAT
ACADEMIC QUALIFICATIONS
10. MATRICULATION SSLC CBSE ICSE OTHERS (.) PERCENTAGE MARKS
11.
PLUS 2
AISSC
ISC
HSS
THSE
PDC
OTHERS (.)
PERCENTAGE MARKS
12.
GRADUATION
[Link]
B.A.
[Link]. COLLEGE
[Link]
BBA
OTHERS (.) MAIN SUBJECT/BRANCH
UNIVERSITY
MAX MARKS
MARKS SECURED
PERCENTAGE
13.
POST GRADUATION UNIVERSITY
M.A.
[Link].
[Link]
[Link]
OTHERS (.) MAIN SUBJECT/SPECILISATION
COLLEGE
MAX MARKS
MARKS SECURED
PERCENTAGE
EMPLOYMENT DETAILS
14. DESIGNATION
NAME OF ORGANIZATION TOTAL EXPERIENCE IN YEARS
A Demand Draft for Rs. 550/- drawn in favour of FISAT payable at Aluva/Ernakulam towards the cost and postage charges of Application form must be enclosed.
D. D No. Date Bank
Branch
Amount
EXTRA CURRICULAR / CO-CURRICULAR ACTIVITIES
15. LITERARY / CULTURAL ACTIVITIES
16.
SPORTS AND GAMES
17.
HOBBIES
18.
MEMBERSHIP IN PROFESSIONAL BODIES
19.
DETAILS OF PERSONALITY DEVELOPMENT PROGRAM ATTENDED
DECLARATION
I hereby undertake on being admitted to the college, to abide by the rules and regulations of the college during the course of my study. I will not engage in any undesirable activity either inside or outside the College that will adversely affect the orderly working, discipline and the reputation of the College.
20.
PLACE
DATE
SIGNATURE OF CANDIDATE
If my son/daughter/ward is
21.
admitted to the college, I hereby undertake to see to his/her good conduct and discipline within and outside the college.
PLACE
DATE SIGNATURE OF PARENT/GUARDIAN
22.
Documents to be produced with this application: (a) Copy of MAT Score* (b) Copy of Marklist/and Pass Certificate of Plus2/Equivalent Exam (c) Copy of SSLC/Secondary Exam Certificate (d) Copy of Marklist & Degree/Post Graduate Degree* (e) Copy of Experience Certificate, if any * If not published, send copy as soon as the result is published.
Last Date of Submission of filled form: 03-03-2010
For Office use
Verified
Superintendent Date
Principal Date