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Programme applied for (please tick) *Certified programmeDiplomaDegreeMBA

Name of the programme (please specify) *

Name of the student (in capital letters) *

Father's Name *

Permanent Address (in capital letters) *

District *

State *

Pin Code *

Guardian Phone Number *

Mobile Number *

E-mail ID *

Guardian Address (in capital letters) *

District *

State *

Pin Code *

Guardian Phone Number *

Mobile Number *

E-mail ID *

Age *

Date of Birth *

Sex *MaleFemale

Marital Status *SingleMarried

Nationality *IndianOthers

Religion

Academic Information

SSLC : Name of School *

SSLC : Year of Passing *

SSLC : Exam Authority *

SSLC : % Obtained *

H.S.C: Name of School *

H.S.C : Year of Passing *

H.S.C : Exam Authority *

H.S.C : % Obtained *

Others: Name of School/College

Others : Year of Passing

Others : Exam Authority

Attach the copies of mark lists and certificates to prove eligibility

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Joys Institute of Management Studies, Habisila Building, 327-C, MKK Nair Rd, Palarivattom, Kochi, Ernakulam, Kerala 682025

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