Xime Application Record

 Xime Application File Composition

XIME APPLICATION NO 182012

XAVIER INSTITUTE OF MANAGEMENT & ENTREPRENEURSHIP

Send: 080-2852 0809 E-mail: [email protected] org Internet site: www.xime.org

APP FOR TWO-YEAR PGDM SYSTEM

1 . (a) XAT ID (2012)

(b) CAT Sign up No . (2011)

(c) XAT Score inpercentile (2012)

(d) CAT Credit score in percentile (2011) -- in lieu of XAT

2 . Preferred GD/Interview Center Bangalore Chennai Hyderabad Kochi

(Please circle)

3. Name(incapitallettersasinDegreeCertificate/MarkSheet)

Date of birth LOGISTIK YYAge as on 1/7/2011DD

Gender Relationship status Hitched UnmarriedM/F

Candidatestoaffix passport size photo Religion Mom tongueand indication across

Category SC ST BC OBC Others

(Tick)

Nationality NRI Yes No

Details of Parents Dad Mother

Identity

Occupation / Current Job

4. Sending Address with PINPermanent Addresses with FLAG

Contact: Tel No . (with STD code): Tel Number (with AN STD code):

Current email address:

Mobile No .

5. Languagesknown(otherthanEnglish):

LanguageReadWriteSpeak

6th. Academic Record

Year Brand of School, Significant Total Max.

Marks Degree

%

(Aggregate) From - ToBoard, College or university SubjectsMarks

University or college & PlaceobtainedMarks

Std Back button

Std XII / PUC

Degree W. A. / B. Sc/

B. Com. /B. Technical.

one applicable)

(P

Other folks (specify)

L. G. Degree

(specify)

Various other Recognized

Course(of duration

12 months or more)

** Applicants are required to include a college degree from a recognized university with a minium aggregateof50%forallsubjectstakentogether(45%forSC/STcandidates)

six. Awards, Scholarships, andSignificantAchievements(Bespecific)

LevelAcademicsSports / GamesCultural Events

School Level

(upto 2nd position)

College Level

(upto next position)

University or college / Condition Level

(upto 10th position)

National level

(upto 20th position)

NCC / NSS ParticipationYes Simply no

If Yes, give details

8. ListWorkExperiences(ofdurationatleast6months)

Particular date

OrganizationDesignationAnnual SalaryReasons for Giving

FromTo

Describethenatureofworkandresponsibilitiesassociatedwithyourmostrecentjob

9. ExplainwhyyouhavechosentostudyatXIME.

10. HowdidyoucometoknowaboutXIME? (pleaseP)

NewspaperMagazineCoaching centreOther resources (specify)

websiteXIME StudentAlumniXIME

14. Have you ever before applied to XIME before? Certainly No

If you do, mention yr

CARDXIME SOFTWARE NO 18INTERVIEW

Ifyouarefoundeligible, youwillbesentaninterviewcard. Pleasewritewithintheboxbelow a message and mailing address, where you want them the interview card to be sent.

You should write in capital characters

E-mail treat:

Declaration

I hereby declare the fact that particulars succumbed this program are the case and correct increase in supportedbyoriginaldocumentswhenrequired. IconfirmthatIhavefullyreadthetermsand conditions about the admissiion to XIME's PGDM programme and...

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