Vidya Prasarak Mandal’s
Dr. V. N. Bedekar Institute of Management Studies
(Dr. V. N. BRIMS)
’Jnanadweepa’, Chendani Bunder Road Thane (MS) India. 400601
Tel: No. (91-22) 2536 4492, 2536 9868 Fax: (91-22) 2544 6554
email: vnbrims@vpmthane.org
Website: www.vpmthane.org
Application for Approved MSBTE Courses batch 2007 - 2008

Instructions :

  1. Please complete the form fully. All fields marked with * are compulsory.
  2. After verifying that you have filled the form correctly and fully, click on the submit button to submit the form. Please submit a form only once
  3. Print the summary page presented to you on the next screen after clicking submit button.
  4. This form will be considered for admission only if you have submitted the printout along with necessary document copies AND paid the form fees.
  5. You can submit the form at the institute or can send the same along with a DD/Cash for Rs 250/- for Group Discussion/Personal Interview on or before 30th June 2007.

To,

The Director,
VPM's DR. VN BRIMS
Thane.

Dear Sir,

I hereby apply for admission to
i ) Advance Diploma in Business Management Sciences
ii)

Student Information :

Surname *
First Name *
Middle Name *
Correspondence Address Line 1 *
Correspondence Address Line 2
Correspondence Residence City *
Correspondence Pincode *
Correspondence Phone Number
Email Address *
Permanent Residence Address Line 1 *
or
Permanent Residence Address Line 2
Permanent Residence Address City *
Permanent Residence Address Pincode *
Permanent Residence Address Phone Number
Parent's Office Address Line 1
Parent's Office Address Line 2
Parent's Office Address City
Parent's Office Address Pincode
Parent's Office Address Phone Number
Date of Birth * dd-mm-yyyy format only. Example 29-12-1971
Birth Place District & State*
Rural / Urban * Rural or Urban
Gender * Male or Female
Married ? * Married / Un-Married / Widow(er)
Nationality *
Father's / Husband's / Mother's Name *
Father's / Husband's / Mother's Occupation *

Place :

Date :

Signature

ACADEMIC PROFILE *

i) Basic Degree *
( To be taken as Qualifying Examination)
ii) Name of the University *
iii) Details of examinations passed (Matriculation & above)
Name of Exam or Course  
S. S. C. / I. C. S. E. / C. B. S. E. * Board / University *
School / College *
Year of Passing *
mm-yyyy format only. Example 09-1999
Marks Obtained *
Marks Outof *
% * e.g. 80.00, 79.87 etc
Remarks
H. S. C. / I. S. C. * Board / University *
School / College *
Year of Passing *
mm-yyyy format only. Example 09-1999
Marks Obtained *
Marks Outof *
% * e.g. 80.00, 79.87 etc
Remarks
B.A. / B.Com. / B.Sc. / B.E./ B.Pharm * Board / University *
School / College *
Year of Passing *
mm-yyyy format only. Example 09-1999
Marks Obtained *
Marks Outof *
% * e.g. 80.00, 79.87 etc
Remarks
Post Graduate Degree / P. G. Dimploma Board / University
School / College
Year of Passing
mm-yyyy format only. Example 09-1999
Marks Obtained
Marks Outof
% e.g. 80.00, 79.87 etc
Remarks

WORK EXPERIENCE : Full Time / Part Time

 
Current Job
Previous Job
Organisation
Designation
Full / Part Time
Period
From To From To
Yrs Month Yrs Month
Duration Total Yrs.
Yrs Month
Salary P.A.

Please verify the correctness of the data before clicking submit.