sinhgad

Sinhgad Technical Education Society's
DISTANCE EDUCATION CENTRE
SINHGAD INSTITUTE OF MANAGEMENT
(Approved by Distance Education Council, New Delhi)
47/2, ‘B’ Govind Chambers, Opp. Maharshi Karve Telephone Exchange,
Karve Road, Above Hotel Girija, Nalstop, Pune – 411 004
Tel.Nos.: +91 20 25421350, 25459228 / Telefax: 25459228
website : www.sinhgad.edu email : infosiomdec@sinhgad.edu

APPLICATION FORM FOR ADMISSION TO MANAGEMENT PROGRAMME – 2008-09

PRN No
(for office use only)

Affix Your Recent
Passport Size
Photograph Duly
Attested By You

Name of Programme*

Programme code*

IMPORTANT :

Complete Form along with certificates / details mentioned in the checklist and the prescribed programme fee should be sent to the SIOM’S – DISTANCE EDUCATION CENTRE PUNE. Fees for Diploma programme should be paid by Demand Draft and to sent along with the application Form.

Center Code*

Demand Draft Details :

*D/D Number	*D/D Date
*D/D Number	*D/D Date	Date	Month	Year

*D/D Amount	*Bank Name

Name

*FIRSTNAME

*MIDDLENAME

*SURNAME

Father’s/Husband’s Name

(a) Address for Correspondences: House/Flat No, Building, Street/Village (Do not write Father’s OR your name here OR Father’s Address)*

Taluka / Block

District

State

Pin Code

(b)Telephone Number
with STD Code

(c) Fax Number
with STD Code

(d) Mobile Number

(e) E-mail*

Sex*

10.

Date of Birth*

Date

Month

Year

11.

Nationality

Indian Others

12.

Category*

13.

Whether physically handicapped Yes No

14.

(a) Educational Qualifications : Graduation only (B.A, B.COM, B.S.C., B.E, B.C.A, B.C.S etc.)

Qualification

Year of Passing

Percentage of Marks

(b) Post Graduation : if any (M.A., M.COM. M.SC. etc.)

Qualification

Year of Passing

Percentage of Marks

15.

Work Experience (latest employment detail) :

Total No. of Years

Year Month

Name of Organisation

Place

Designation

16.

Entrance Test

Have you appeared for qualifying entrance examination :

If Yes: Please attach Score Card

Name of the Examination

Entrance Test On-line / Manual at SIOM-DEC Centre OR ATTEST centre

Test Centre Name

Entrance Test Code No.

DECLARATION BY APPLICANT

I hereby declare that I have read and understood the conditions of eligibility for the programme for which I seek admission. I fulfil the minimum eligibility criteria and have provided necessary information in this regard. In the event of any information being found incorrect or misleading, my candidature shall be liable to cancellation by the university at any time and I shall not be entitled to refund of any fee by me to the SIOM - DEC.

I have carefully studied the rules of the SIOM - DEC as printed in the Prospectus and I accept them and shall not raise any dispute in future over the same rules

Date :

Signature of the Candidate

Note:

Prospectus - with application form Price Rs. 1500 for the two year Post Graduate Programme & Rs 1000/- for the one year Diploma Programme.
The Application and Enrollment-cum-Registration Form can be obtained through Demand Draft, drawn on any Nationalized Bank, Payable to SIOM-DEC, Pune and sent above given address.
Demand Draft to be enclosed with Application Form
Completed Application Form should reach SIOM-DEC on or before 05/05/2008.

ENTRANCE TEST IDENTITY CARD

Online : | Manual :

PRN No
(Office Use only)

Affix Your Recent
Photo

Attested by
SIOM-DEC Authority

Center Code No

Name

Date of Exam

Date

Month

Year

Name of Programme

Student Sign :

_________________________________________________________________

ENTRANCE TEST IDENTITY CARD
Sinhgad Technical Education Society's
DISTANCE EDUCATION CENTRE
SINHGAD INSTITUTE OF MANAGEMENT
(Approved by Distance Education Council, New Delhi)
47/2, ‘B’ Govind Chambers, Opp. Maharshi Karve Telephone Exchange,
Karve Road, Above Hotel Girija, Nalstop, Pune – 411 004
Tel.Nos.: +91 20 25421350, 25459228 / Telefax: 25459228
website : www.sinhgad.edu email : infosiomdec@sinhgad.edu
_______________________________________________________________
Online Entrance Test : 6 May to 22 May 2008
Manual Entrance : Test : 25th & 26th May 2008

Entrance Test ID Card Single Attempt Only

APPLICATION FORM FOR TERM END EXAMINATION – 2008 - 09

Application Form/ PRN No
(for office use only)

Name of Programme

Programme code

Semester

Exam Centre Code
From where ,you wish to Appear

Name

FIRSTNAME

MIDDLENAME

SURNAME

Please fill up correct course and complete course tittle in which you take the examination, Also fill up the course, the result of which has not yet been declared. The Course(s), which you have already passed should not be mentioned since improvement of score / grade is not permissible.

Sr.No	Course Code	Course Tittle
01
02
03
04
05
06

Backlog: if any

Sr.No	Course Code	Course Tittle
01
02
03
04
05
06

I hereby solemnly affirm that I have submitted/will submit, all the required number of assignments prescribed for the above course(s) within the deadlines prescribed by the SIOM DEC to the appropriate authority for evaluation.

I am aware that submission of assignments prescribed for these courses is a pre-requisite for taking Term- End Examination. I also state that my registration for the above courses valid and not time barred.

I undertake that shall abide by the rules and regulations of the SIOM - DEC . I have signed this undertaking on this ________________________ day ____________ of 200

Signature of Student

Note:

Please superscribe “Examination Form” on the top of envelope
Please write your Enrolment Number and programme on the reverse side of draft
Please submit the exam form upto _____ / _____ / __________ to the address mentioned below and nowwhere also prelerably by Regd. post/Speed Post.
Exam Form should be submitted before the Term End Exmination

The Register
SIOM-DEC,Pune

INSTRUCTIONS FOR FILLING UP THE FORM OF EXAMINATION

1. Please attach a self-addressed post card, if acknowledgement is desired. If you are sending your examination form through Regd. Speed Post or Courier, Please retain the proof of its mailing till your receive the Examination Intimation Slip.

2. Students should submit the examination form only once for each Term-end Examination.

3. It is advisable that students fill-up the examination form without waiting for the result of the previous exam.

4. If you do not receive Examination Intimation Slip one week before commencement of examination, please contact your Examination Centre/Study Centre. If your name exists in the list of the registered candidates, you can take examination by showing your identity card. You can also visit our website www.sinhgad.edu in and download Examination Intimation slip.

5. a) In case you wish to take examination at a particular Centre the code of your chosen centre be filled up as exam centre code.
b) If Exam Centre chosen by you is not activated, you will be allotted another exam. Centre
under the same region.
c) Change of examination centre, once allotted, is not permissible under any circumstances.

6. Only such candidates shall be eligible to appear at the examination who have paid necessary
programme fee and their registration is valid for the courses for which they wish to appear and
also have completed minimum prescribed period.

7. Please write correct course code(s) and complete title of course(s) as indicated in your Programme Guide failing which computer will not print you relevant course code in “intimation slip. for taking examination.

Example: [SIOM-DEC-02] PGDMM (Post Graduate Diploma in Marketing Management) & Diploma In Marketing Management [SIOM-DEC06] (DMM)

8. List of attested copies of Certificates to be enclosed: (as applicable)
a) 10th / S.S.C. Certificate including mark list
b) 12th / H.S.C. Certificate including mark list
c) Diploma Certificate including mark list
d) Graduation Certificate including mark list
e) Post Graduation Certificate including mark list
f) Migration Certificate from last university
g) Experience Certificate
h) Entrance Exam Score Card

9. Entrance Test Code No. to be fillup in the application form