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Apply Online

Choose the appropriate courses* : ( Affix latest Passport size Colour Photograph)

Instructions

  • Read the application form carefully before you fill it.
  • Please use ( √ ) tick mark in appropriate boxes wherever required.
  • The application form will be attended only if all the required information is included. Please re-check form to ensure you have not left any data un-filled.
  • All Information you provide will only be used by our Admission Department and will remain strictly confidential.
 
Personal Details
Student Name in Full (in Capital Letters as in Class X records) :
Date of Birth :
Address :
City/Town :
State :
Country :
Pin code :
 
Gender : MaleFemale
Caste: (SC/ST/BC/OC) :
Mobile :
Landline (area code first) :
Mother Tongue :
E-mail :
 
If different from the above, please give your permanent address
Address :
 
Mobile :
Landline (area code first) :
     
Family Details
Mother's/Spouse's Full Name :
Occupation :
Name of Organisation :
Contact No. :
 
Father's Full Name :
Occupation :
Name of Organisation :
Contact No. :
 
Academic Qualification (From Class X Onwards)
Course Board University Medium of Instruction Year of Passing Class / Division % of Marks
Class X *
Intermediate/XII *
Graduation *
(Specify Degree)
Others (Specify)
* Candidates who have appeared for the Final year degree have to mention the average marks upto the previous year (eg. fourth year Engg. students must submit marks upto 3rd year).
 
Name of the Graduation College Graduation Degree Contact No. College Address
 
Work Experience
Organisation Designation Years of Service Nature of Work
 
Test Information
Test Date taken / To be taken Regn. No. Composite Score / Total Score Percentile
CAT
XAT
MAT
ATMA
Other All India. Tests (Specify)
 
Statement of purpose (including academic honours, extracurricular activities etc.,)
How did you get to know about VJIM? :
 
*Specify :

Declaration by Applicant:

I declare that all information in my application is complete, factually correct and honestly presented. I have read the rules and regulations mentioned in the admission brochure and will adhere to the same. I also understand that fees once paid will not be refunded under any circumstances.

Date :
 
Place :
     
Enclosures

Demand Draft

Photo Copy of :  

CAT/MAT/XAT/CAMT/ATMA Score Sheet

Graduation Certificate / Marks Sheet

Certificate from Principal that candidate will be appearing for the final year exam in Mar / Apr 20

Character certificate from Principal of the Institute studied last.

For Office Use
     
Receipt No.: :
Date: :
*After you submit the form you will be prompted to make the payment.
 

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