Ph.D.Admission   Ph.D.Admission   Ph.D.Admission  
ADMISSION FORM
To,

The Director,
Institute of Management.
Research & Technology.
M.V.P. Campus, Gangapu Road.
Nashik-422 002.
Respected Sir / Madam.

I may please granted admission to the   course in your Institute. I declare that the information given below is correct & that I agree to abide by the rules and regulations of the Institute. I undertake that I shall do nothing that will interface with the discipline or damage the reputation of the institute.
Name :
  Surname
   Name
   Father's/Husbhand's Name
Mother's Name :
Address for Correspondence (Local) :
Address for Correspondence (Permanent) :
Pin Code :
Phone Resi :
Name & Address & mob No Local Guardian's :
E-mail ID :
Student Mobile No :
Parent Mobile No :
Date Of Birth :
 
Caste :
Religion :
Academic Record :  
Examination or
Degree
(write Faculty)		 Years of Passing Name of the University / Institute Subject (special) offered at degree Level Mark's obtained out of Percentage Grade
S.S.C. / %
H.S.C. / %
Degree / %
P.G. / %
Date :
Place :
For Office Use Only
Security fees Rs. ____________________ Receipts No. ____________________ Dated:
Admission fees Rs. ____________________                                                     Dated:
PRN No. (IMRT):
Provisionally addmitted to ________________________________________
Checked by Clerk Director

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