Application Form for Global MBA (M.Sc. – Track) Program
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Instructions for the applicants, visit : https://www.xub.edu.in/XEBS/global-mba(M.Sc. - Track).html
Personal Details
1. Applicant Name: *
2. Email ID: *
3. Mobile Number: *
4. Date of Birth: *
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5. Age: *
6. Gender: *
7. Alternate Email ID:
8. Alternate Phone Number:
9. Are you a domicile/native of Odisha ? :
10. Nationality:
11. If Nationality is Others? Please Provide Passport Number:
Family Details
12. Father's / Guardian's Name: *
13. Mother's Name: *
14. Present Address (for correspondence)
14(a) Address line-1 *
14(b) Address line-2 *
14(c) city *
14(d) Pincode *
14(e) State *
14(f) Country *
15. Permanent Address
15(a) Address line-1 *
15(b) Address line-2 *
15(c) city *
15(d) Pincode *
15(e) State *
15(f) Country *
Highest Educational Qualification
Highest Educational Qualification (Completing or Completed) *
Specialization *
Education-X
Please Enter 0 (zero) if Not Applicable
A1. Board - Std. X *
A2. School - Std. X *
A3. Date and Year of Completion - Std. X *
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A4. Percentage of Marks/CGPA - Std. X *
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Education-XII
Please Enter 0 (zero) if Not Applicable
B1. Board - Std. XII *
B2. School / College - Std. XII *
B3. Year of Completion - Std. XII *
B4. Branch / Discipline - Std. XII *
B5.Percentage of Marks/CGPA - Std. XII *
Education - Bachelor's Degree
Please Enter 0 (zero) if Not Applicable
C1. Degree Name *
C2. University - Degree *
C3. Year of Completion - Degree *
C4. Name of the Institute - Degree *
C5. Branch / Discipline - Degree *
C6. Results Declared - Degree *
Education - Master's Degree/Equivalent
Please Enter 0 (zero) if Not Applicable
D1. Master's Degree Name *
D2. University - Master's *
D3. Year of Completion - Master's *
D4. Name of the Institute - Master's *
D5. Branch / Discipline - Master's *
D6. Results Declared - Master's *
Education - Others
Please Enter 0 (zero) if Not Applicable
E1. Qualification - Others *
E2. University - Others *
E3. Year of Completion - Others *
E4. Name of the Institute - Others *
E5. Branch / Discipline - Others *
E6.Result Declared - Others *
Work Experience
Do you have fulltime work experience? *
Total Experience in months as of 31st May, 2018 *
Briefly describe your responsibilities associated with your current job (Maximum three sentences) *
Organization Name-1
Designation-1
Start Date-1
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End Date-1
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Durations in Months-1
Annual Salary in Lakhs(INR)-1
Organization Name-2
Designation-2
Start Date-2
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YYYY
End Date-2
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Durations in Months-2
Annual Salary in Lakhs(INR)-2
Application Fee Payment
Application Fee *
Amount of Rs. 1500
Documents
Photo *
Required
Signature *
Required
Declaration
I hereby declare that the particulars given in this application form are true and correct, and they will be supported by original documents when asked for. I am also fully aware that in the event of any information found incorrect or misleading, my candidature shall be liable to cancellation by the university at any time.
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