Lalit Narayan Mishra College of Business Management

GO TO HOMEAPPLICATION FORM

Admission Details

Application for admission as a student for:*		Special Needs /Disability:
Source of information for the course:*		Do you seek reservation?

PERSONAL DETAILS

Name:*

Photo:*
jpeg, jpg, gif, png

Father's Name:*

Father's Occupation:*

Mother's Name:*

Mother's Occupation:*

Gender:*

MaleFemale

Marital Status:*

SingleMarried

DOB:*

Age:*

Place of Birth:*

Nationality:*

Domicile:*

Email Address:

Permanent Add.:*

Corres. Address:*

Permanent Pin Code:*

Corres. Pin Code:*

Permanent Contact No:*

Contact No.:*

ENTERANCE DETAILS

Name of Eligibility Test:		Month & Year:
Composite Score:	Percentile:	Attach Score Card:

Qualification Details *

SrNo	Degree	Class/Grade	Subject	College/School	Borad/University	Year
1
2
3
4
5
6

Additional Qualification (if any):-

Employment And Work Experience

SrNo

Brief description of work and responsibility

Name of employer

Date of employment

Payment Details *

SrNo

DD No.

DD Date

Bank

Branch

Amount[Rs.]

For Emergency Contact

Name:*

Relation:*

Mob. No.:*

I hereby declare that the particulars given in the application form are correct to the best of my knowledge and belief. The application, if found incorrect, my candidature can be rejected.

Please enter the number on photo.