XIME APPLICATION NO 182012 XAVIER INSTITUTE OF MANAGEMENT & ENTREPRENEURSHIP Fax: 080-2852 0809 E-mail :[email protected]org Website: www. xime. org APPLICATION FOR TWO-YEAR PGDM PROGRAMME 1. (a) XAT ID (2012) (b) CAT Registration No. (2011) (c) XAT Score inpercentile (2012) (d) CAT Score in percentile (2011) – in lieu of XAT 2. Preferred GD/Interview Centre Bangalore Chennai Hyderabad Kochi (Please circle) 3. Name(incapitallettersasinDegreeCertificate/MarkSheet) Date of birth MM YYAge as on 1/7/2011DD Gender Marital status Married UnmarriedM/F
Candidatestoaffix passport size photograph Religion Mother tongueand sign across Category SC ST BC OBC Others (Tick) Nationality NRI Yes No Details of Parents Father Mother Name Occupation / Current Job 4. Mailing Address with PINPermanent Address with PIN Contact : Tel No. (with STD code) : Tel No. (with STD code):
Email address : Mobile No. 5. Languagesknown(otherthanEnglish): LanguageReadWriteSpeak 6. Academic Record Year Name of School, Major Total Max. Marks Qualification % (Aggregate) From – ToBoard, College SubjectsMarks University & PlaceobtainedMarks Std X Std XII / PUC Degree B. A. / B. Sc/ B. Com. /B. Tech. one applicable) (P Others (specify) P. G. Degree (specify) Other Recognized Course(of duration 1 year or more) ** Applicants are required to have a bachelor’s degree from a recognized university with a minium aggregateof50%forallsubjectstakentogether(45%forSC/STcandidates) . Awards, Scholarships, andSignificantAchievements(Bespecific) LevelAcademicsSports / GamesCultural Events School Level (upto 2nd position) College Level (upto 2nd position) University / State Level (upto 10th position) National level (upto 20th position) NCC / NSS ParticipationYes No If Yes, give details 8. ListWorkExperiences(ofdurationatleast6months) Date OrganizationDesignationAnnual SalaryReasons for Leaving FromTo Describethenatureofworkandresponsibilitiesassociatedwithyourmostrecentjob 9. ExplainwhyyouhavechosentostudyatXIME. 10. HowdidyoucometoknowaboutXIME? (pleaseP)
NewspaperMagazineCoaching centreOther sources (specify) websiteXIME StudentAlumniXIME 11. Have you ever applied to XIME before ? Yes No If Yes, mention year CARDXIME APPLICATION NO 18INTERVIEW Ifyouarefoundeligible, youwillbesentaninterviewcard. Pleasewritewithintheboxbelow your name and mailing address, where you want the interview card to be sent. Please write in capital letters E-mail address : Declaration I hereby declare that the particulars given in this application are true and correct and will be supportedbyoriginaldocumentswhenrequired. IconfirmthatIhavefullyre dthetermsand conditions regarding the admissiion to XIME’s PGDM programme and pursuit of the same including those relating to withdrawal from the programme after admission. Place…………………………. Date…………………………… Signature of the applicant Candidatemustaffixapassportsizephotointheboxgivenintheinterviewcardandsign across. Candidateshouldwritehis/hernameintheboxatthebottomoftheinterviewcard. Other entriesintheInterviewCardwillbefilledatXIME. OfficeUse XIME APPLICATION NO 18For Interview date Interview batch no. Reporting time
Interview centre Bangalore Chennai Hyderabad Kochi CARDXIME APPLICATION NO 18INTERVIEW Interview dateReporting timeInterview batch no. Address of Interview Centre Candidatestoaffix passport size photograph and sign across Name of applicantXIME seal XAVIER INSTITUTE OF MANAGEMENT & ENTREPRENEURSHIP Electronics City, Phase-II, Hosur Road, Bangalore – 560 100, Tel : 080 – 2852 8597 / 98 Fax: 080-2852 0809 E-mail :[email protected]org Website: www. xime. org APPLICATION FOR TWO-YEAR PGDM PROGRAMME Instructions for filing the Application Form
Applicants are advised to send the completed application form and other documents such as scorecardorcertificates, throughregisteredpostorcouriertoensuredelivery. Ifyouhavedownloadedtheapplicationformfromourwebsite, pleasedonotfilltheapplication number. ThiswillbefilledbyXIMEAdmissionOffice. The item numbers refer to the serial numbers in the application form. Item 1 c The XAT score (Total Percentile) should be entered if received at the time of application. A photocopy of the XAT Score card should be attached with application form. Item 1 d Alternatively, the CAT Score (Total Percentile) should be entered if eceived at the time of application. A photocopy of the CAT score card should be attached with the application form. Item 4. Mailing Address Please provide your email address. This will enable faster communication from XIME. Item 6. Academic Record Under the column Name of School, Board, College, University and Place, you are required to give thenameoftheinstitution, itslocationandaffiliatedboardoruniversity. Example: CollegeofEngineering, AnnaUniversity, Chennai Under the column ‘ Major Subjects’ give the main subjects or electives. Example: ForPUConecanwritePCMtoindicatePhysics, Chemistry, andMathematicsasthe ajor subjects. For Engineering, it can be Mech. with Industrial Engg. and so on Undercolumn‘%ofAggregateMarks’, theweightedaverageofthecumulativemarksobtained in all the subjects including languages and in all the semesters or all the years as the case may be must be given. According to admission rules, applicants must have a minimum of 50% aggregate marks ( 45% for SC/ST candidates) in the degree examination. Refer the Programme Brochure. In case you are yet to appear for the final semester/year examination, cumulative marks of all previous semesters/years must be calculated and entered.
Underthecell‘ Degree’, tickthedegreeapplicable, orspecifythenameofotherdegreeyouhold. e. g. B. Pharm. Item 7 Awards Scholarships and Significant Achievements IfyouhaveanentrytomakeinSports/Gamescolumn, indicateclearlytherankorposition achieved. In‘ CulturalEvents’indicatetheextentofparticipation. Example: Forcollegelevel, underculturalevents, itcanParticipated3timesinanuualdrama events, or for university level under Sports/Games, it can be 2nd prize for high jump in inter- college sports’. Enter only such data that can be substantiated with original certificates at the time of interview.
