Application Form

GOLDEN REGENCY INSTITUTE OF
MANAGEMENT STUDIES

Application for admission in :

Bachelor of Business Administration (BBA) under Punjab Technical University

Master of Business Administration (MBA) under Punjab Technical University

Please fill in BLOCK LETTERS

1. *Surname

2. *Name Mr./Ms.

3. *Name of Father /Guardian

4. *Father's /Guardian's Occupation

5. *Name of Mother

6. *Date of Birth

Calendar

7. *Nationality

8. *Category (Please Tick)

General SC ST OBC

9. *Sex (Please Tick)

Male Female

10. *Address for Correspondence

*City		*P.O.
*Dist		*State
*Country		*Pin
Phone		Mobile

11. *Permanent Address

*City		*P.O.
*Dist		*State
*Country		*Pin
Phone		Mobile

12. E-mail ID

13. Local Guardian’ Name (if any)

14. Contact Number

15. Educational Qualification :

Examination Passed / Appeared	Board / Council / University	Year of passing	Subjects	% of Marks	Division / Class
10th standard

10+2 standard

16. Extra Curricular Activities :

17. Payment details : Amount

Cash

DD No

(Draw the DD in favour of Golden Regency Institute of Hospitality Management, payable at Kolkata)

All fields in * are compulsory

Declaration by the Applicant:

I hereby declare that the information given above are complete and correct to the best of my knowledge. I also confirm that my ward will abide by the rules and regulations as laid by the institute for maintaining proper discipline in the institute.

Declaration by the Guardian:

Testimonials require:

1. Two copies 25x30 mm stamp size recent colour photographs (one affix and one extra)
2. One duly attested photo copy of age proof certificate.
3. One duly attested photo copy of last examination passed certificate.
4. School/college leaving certificate.
5. One duly attested photo copy of SC/ST/OBC certificate, if the candidate falls in any of these categories.