Application No. MBA /2017-19/__________
Affix your latest colored
passport size
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ESTABLISHED UNDER UTTAR PRADESH ACT NUMBER 24 OF 2016
MBA Application Form: 2017-19
SECTION 1 - PERSONAL INFORMATION
1. Name:
(a) First Name __________________________________________________
(b) Middle Name _________________________________________________
(c) Last Name __________________________________________________
2. Parents Information:
(a) Father’s Name _________________________________________________
(b) Mother’s Name ________________________________________________
(c) Parents’ Profession Father __________________________
Mother _______________________
(d) Parent’s Tele. No. Father __________________________
Mother ________________________
(e) Parent’s Qualification (Highest) Father _________________ Mother ________________________
(f) Parent’s Annual Income (combined) - INR ______________________________________________
3. Gender:
M
F
TG
4. Marital Status:
Married
Unmarried
Others (Specify)_______
5. Nationality:
Indian
Others (Specify)___________________________
6. Date of Birth (DD/MM/YYYY):_________________________________
7. Category:
GEN
SC
ST
OBC
8. Preferred Mailing Address
_________________________________________________________________________________________
_________________________________________________________________________________________
State ____________________________________________ Pin Code ________________________
9. Permanent Address (If different than the mailing address)
______________________________________________________________________________________
______________________________________________________________________________________
State _____________________________________________Pin Code ______________________
10. Tele No. (One Tele. No. is Mandatory)
11. (Land Line with STD Code)
_________________________
12. Primary E-Mail ID (Mandatory)
Mobile _____________________
_________________________________________________
13. Mail ID of one of the Parent (Mandatory) _____________________________________________
14. Do you have any specific medical requirements? (Specify)
___________________________________________________________________________________________
___________________________________________________________________________________________
SECTION 2 - QUALIFICATION /ELIGIBILTY INFORMATION
15. Application to be considered under NRI/NRI Sponsored/Foreign National Category Seats
(State Yes/No) __________
(Read Fee structure and Guidelines in Admission procedure document)
16. Current Qualification (Do not forget to attach copy of marks sheet - Mandatory)
Year of
Completion
Board / College and
University
Stream#
% of Marks/CGPA with
equivalent percentage
10th
12th
Graduation*
Others (if any)
*If appearing, state ‘Appearing’ under the year of completion. You must ensure that that your last paper of final graduation examination finishes before 15 July 2017.
# [e.g. Science / Arts / Commerce / Engineering with branch like B Tech-CSE etc / others (specify)
17. Please Fill as Applicable
(A) CAT
*
Month and Year
Quant Ability
(QA)
Score
%ile
Data Interpretation and Verbal and Reading
logical reasoning (DILR)
comprehension
Score
%ile
Score
%ile
Total Composite
Score
%ile
(B) GMAT*
Date/Month/Year
Quantative
Verbal
Total
Analytical
Writing
Integrated
Reasoning
Score/%ile
Score/%ile
Score/%ile
Score/%ile
Score/%ile
(C) XAT*
Month and Year
Decision Making
Percentage
(D) GRE
%ile
Quantative ability
and Data Interpretation
Percentage
%ile
Total
Verbal and
logical ability
Percentage
%ile
Percentage
%ile
*
Month and Year
Verbal Reasoning
Scaled Score
% below
Quantative Reasoning
Scaled Score
Analytical Writing
% below
Score
% below
* Attach copy of Score Card. In case, result is awaited, state so under 'Total Score' column(Month/Year Column in case of GRE). However, you must upload the result online once available or send scorecard to the Admission Department before last date of application.
SECTION 3 - ACTIVITIES/HONORS/EXTRA CURRICULLAR
18 Work Experience (if any) - Attach separate sheet, if required.
Position
Name of Organization
Job Profile
Period (From --To)
19 Extra-Curricular Activities (Not more than 200 words) - Attach separate sheet, if required.
Activity
Organization
Brief Description of Activity
20 Honours and Awards/Scholarships (Not more than 200 words) - Attach separate sheet, if required.
Type of Honor/Award
Dates/Year received
Basis of Selection
21 Significant achievements - Attach separate sheet, if required.
Type of Achievement
Month/Year
Description (in not more than 20 words per achievement)
22 Describe how will the MBA at Bennett University help you in achieving your career goals?
(Not more than 200 words) - Attach separate sheet if required
23 Details of Bank Draft (Only in case of Downloaded Application)
(a) DD N
(b) Date of Issue
(c) Bank
______________________________________________________________
SECTION 4 - HONOR POLICY AND CONDUCT STATEMENT
24.
I undertake to adhere and comply with Bennett University Honour Policy as below:
We, the members of the Bennett University - students, faculty and staff - shall work together in striving for
excellence in every aspect of our University’s activities. We seek to be a model of how members of an
academic community can combine their spirit and talents to achieve such institutional excellence.
We understand that in striving for excellence, our personal institutional integrity is our most precious asset.
Accordingly, we accept accountability for our behaviour and will not knowingly act in ways that might
damage that integrity. We commit ourselves to performing our work and fulfilling our responsibilities
honestly and professionally. In particular, we will not tolerate cheating of any sort by any member of our
community in any situation.
We shall treat each other with respect, honouring the dignity and value of each member of our community.
We will cooperate with each other and fulfil our mutual commitments. We will extend these same
courtesies to our guests.
We pledge to share community assets, such as facilities, library materials and the information technology
resources, in ways that are responsible, that comply with established policies and that reflect the principle
of fairness. We accept adherence to these values as a condition of membership in the Bennett University.
Finally, we accept adherence to the Academic Honour Code and Code of Student Conduct as a condition of
membership in the Bennett University.
SECTION 5 - GENERAL INSTRUCTIONS
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Mail this completed form to the address given below (with valid CAT/GMAT/XAT/GRE score
card, (if result are available). The scores may be provided on line when announced. Alternatively,
hard copy of the result card should be sent to the University office before last date of application,
along with the following attachments:
(i) Copy of 10th, 12th & Graduation marks sheet, if completed or mark sheet upto Pre Graduation
Examination.
(ii) One recent passport size colour photograph (pasted on the application) or upload if applying on line.
(iii) Attach a Demand Draft of Rs. 1000/- in favour of Bennett University payable at Noida /Greater
Noida
(iv) No demand draft needs to be attached in case the application form has been purchased from the
University office.
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DECLARATION
I, declare that all statements made in this application for admission are correct and complete. I, also
understand that plagiarism, submission of false information, or omission of relevant information or
credentials may result in my application being withdrawn, my admission being denied, or my admission
being revoked.
I, also understand that I have read the admission procedure document and the submission of application
does not automatically qualify me for interview/further selection process. The Application Fee is nonrefundable under any circumstances
Further, I understand that Ragging is banned in the University. If I am found indulging in ragging, at any
stage of my study period, I shall be liable for disciplinary action; including expulsion from the University.
Date ____________________ Signature _____________________________________________________________
Place ____________________ Name _______________________________________________________________
IMPORTANT GUIDELINES /INFORMATION
Terms and Conditions for Eligibility
(a)
Bachelor’s Degree or its equivalent in any discipline from a statutory university with at least 50%
aggregate marks or equivalent CGPA. Candidates graduating in 2017 can also apply but must prove
their eligibility latest by 30 October 2017. Further, they must ensure that their last paper of final
graduation examination finishes before 15 July, 2017. Those not producing the eligibility certificates
as per the date mentioned will be disqualified/de-registered irrespective of them having joined the
program provisionally.
(b)
Applicants seeking admission are required to have qualified in CAT/GMAT/XAT/GRE with validity
up to July 2017 or beyond. CAT/GMAT/XAT/GRE examination is not mandatory for candidates
applying under NRI/NRI Sponsored/Foreign National Category Seats.
(c)
Few seats are available under NRI /NRI sponsored/Foreign National Category. Such candidates can
apply with criteria at (a) and (b) above.
Shortlisting / Selection Process
(A)
Shortlisting of Candidates:
(a) Following factors would generally be considered for shortlisting and inviting candidates for the
personal Interview (PI):
(i) Score/percentile in CAT/GMAT/XAT/GRE.
(ii) Consistency and strong past academic record.
(iii) Relevant work experience (if any) that brings value to the classroom learning.
(iv) Extra–curricular achievements reflecting leadership qualities, contribution to society and a
well-rounded personality.
(v) For NRI/NRI Sponsored/Foreign National Category candidates marks in graduation shall
determine the eligibility for being called for PI.
(b) Only candidates short-listed on the basis of relative merit amongst received applications will be
called for a PI, which may be held in Greater Noida / Delhi / Chandigarh / Lucknow / Patna /
Jaipur/ Mumbai / Bengaluru /Hyderabad (subject to adequate number of applications from the
region).
(c) Submission of application does not automatically qualify the candidate for participating in further
selection and no refund of application fee will be done for any reason whatsoever.
(B)
Selection:
(a) The final results shall be drawn based on the candidate’s performance in PI and
CAT/GMAT/XAT/GRE score as adjudged by the University Admission Committee except
NRI/NRI Sponsored/Foreign National Category candidates where marks in PI and graduation shall
determine the Merit.
(b) The discretion of the University’s Admission Committee will be final in all such matters relating
to admissions.
Important Dates:
Issue of Application Forms Starts
: 14 October, 2016.
Expected dates for Personal Interviews (PI) : On-going .Exact dates shall be mentioned in Interview call
letter for shortlisted candidates.
Address to Submit
Admission Section – MBA,
Bennett University, Plot Nos 8-11,
Tech Zone II
Near Dabra Village.
Greater Noida 201310,
Uttar Pradesh, India
Toll free Help line No. 8800 - 444 – 422
University Exchange No. 0120-3948300
Email: [email protected]
Note: Those candidates applying for seat under NRI/NRI Sponsored/Foreign National Category, must
clearly mention same on top of the application form or those applying on line must write an email to
[email protected] quoting name, application No, program applied for and mention willingness to
be considered under NRI/NRI Sponsored/Foreign National category.