SRM Arts and Science College - MBA Application Form (Sample)
1. Personal Information
Name of the Applicant: PAVITHRA M
Date of Birth: 12/06/2004
Gender: Female
Nationality: Indian
Religion & Community: Hindu / BC
Address for Communication: No. XX, XYZ Street,
Chithalapakkam, Chennai - 600073
Mobile: 98765XXXXX
Email: pavithra.m@[Link]
2. Parent / Guardian Details
Father's Name: Muthukumar S
Occupation: Private Employee
Annual Income: Rs. 2,50,000
Phone Number: 98765XXXXX
3. Academic Qualifications
Exam Passed School/College Board/University Year Marks/Grade
10th Std Govt Girls HSS State Board 2020 All Pass
12th Std Govt Girls HSS State Board 2022 391 / 600
BBA ABC College Univ. of Madras 2025 Pursuing
4. Course Applied For
Course: MBA - Master of Business Administration
5. Entrance Exam Details
Exam Name: Not Applicable
Score/Rank: -
SRM Arts and Science College - MBA Application Form (Sample)
6. Declaration
I hereby declare that the information furnished above is true and correct to the best of my
knowledge.
Place: Chennai
Date: 27/05/2025
Signature of Applicant: ______________________
Signature of Parent/Guardian: ______________________
7. Checklist (Tick before submitting)
[X] 10th Mark Sheet (Xerox)
[X] 12th Mark Sheet (Xerox)
[X] UG Semester Marksheets (if any)
[X] Community Certificate (if applicable)
[X] Recent Passport-size Photo (affix on form)