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APPLICATION INSTRUCTIONS

Dear Applicant,
You are important to us.
We have exceptionally high standards for the talent that we take in our programmes. Superior leadership qualities, communication and
interpersonal skills, commitment, problem-solving ability, value driven mindset, professionalism, flexibility, motivation and sharp
intellectual curiosity are expected.
Please read the instructions in the Application Form-2016, carefully before you begin to fill your Application. The Application
form has to be filled in your own clear and legible handwriting and the undertaking is to be signed by you only.
This Application form is valid for the Amity University - Uttar Pradesh, Campuses in Noida, Lucknow, Greater Noida, Dubai and
London, Amity University- Rajasthan, Campus in Jaipur, Amity University - Haryana, Campus in Gurgaon (Manesar), Amity
University - Madhya Pradesh, Campus in Gwalior, Amity University - Chhattisgarh, Campus in Raipur, Amity University --Mumbai and Amity University --- Kolkata

For all details relating to Eligibility & Fee structure kindly refer to the list of programmes at www.amity.edu
Duly filled in Application Form together with a DD of Rs. 1,100/- (if not paid online) in favour of Amity Form payable at New
Delhi should be submitted/sent to the respective campus you are applying to :
Noida, Dubai & London Campus

Gurgaon (Manesar Campus)

Amity Admission Office, Sector-125,


Noida-201 313 (Adj. New Delhi)
Admission Helpline.: 0120-2445252 / 4713600

Amity Admission Office, Amity International School Campus,


Sector-46, Gurgaon-122413, (Haryana)
Admission Helpline.: 0124-2337015 / 16

Lucknow Campus

Gwalior Campus

Amity Admission Office, Malhaur( Near Railway Station),


Gomti Nagar Extension, Lucknow-226 010 (UP)
Admission Helpline:0522-2399418,6525676, 6050071-74

Amity University, Madhya Pradesh,


Maharajpura (Opposite Airport), Gwalior-474 005 (MP)
Admission Helpline.: 0751-3290666 / 3290667

Jaipur Campus

Mumbai Campus

Amity Admission Office, Amity House, 14 Gopal Bari, Ajmer


Road, Jaipur-302006, (Rajasthan)
Admission Helpline.: 0141-2372489 / 2374595

Amity Admission Office, Mumbai --- Pune Expressway, Bhatan,


Panvel, Maharasthra, 410206.
Admission Helpline.: 02143- 205037/8

Greater Noida Campus

Raipur Campus

Amity Admission Office, Plot no.48 A,


Knowledge Park III, Greater Noida (U.P.) - 201308.
Admission Helpline.: 0120-3000000

Amity Admission Office,Raipur --- Manth / Kharora


(Opp. ITBP ) SH --- 9, Chhattisgarh - 493225.
Admission Helpline.: 1800-123-5577

Kolkata Campus
Amity University Kolkata, Action Area II,
New Town, Kolkata.

Visit www.amity.edu (Admission Microsite Login) for all information relating to your application & admission after
submission of application form.

Qualifying candidates can select their date for Admission Process at www.amity.edu (Admission Microsite Login). It is your
responsibility to check the website for selection of date and appear in the Admission Process accordingly. No separate
communication will be sent in this regard.

You are advised to keep a photocopy of the complete application form.

Incorrectly filled, incomplete, unsigned forms & forms received after due date will be rejected.

Forms once rejected will not be reconsidered & form cost will not be refunded.

You cannot apply more than once for the same programme in one admission year.

Enclose class 10th mark sheet only with the Application Form. No other Mark sheets / Testimonials are to be attached with
the Application Form at this stage (Only foreign students / Foreign University Degree holder should attach photocopies of
academic transcripts & AIU Equivalence Certificate). University / Board / Marks filled in the Application Form will be
considered for all procedures related to admission. Any discrepancy found during original document verification will result in
cancellation of Admission.

Amity does not take any responsibility for delay or loss of the material in post/transit.
We do not accept any donations for admission. Merit is the only criteria.
Any instances found, even at a later date, will lead to cancellation of admission.

54487
Application Form Number
INSTRUCTIONS
1. Please read the instructions in the Admission Prospectus-2016 before filling up this form.
2. Use BLACK BALL POINT PEN to write in the boxes using English capital letters or English numerals.
3. Do not make any stray marks on this sheet
4. Do not pin, fold, scribble or tear this sheet.
5. Write in CAPTIAL LETTERS only within the box, in your own handwriting without touching the lines as shown in the
sample below.

5636850

User Name : 5636850


Password : 45b26f

0 1 2 3 4 5 6 7 8 9 A B C D E F G H I

J K L M N O P Q R S T U V W X Y Z

1. NAME OF THE CANDIDATE (as in candidate's class X marksheet or equivalent certificate - enclose photocopy)

2. MOTHER'S NAME (as in candidate's class X marksheet or equivalent certificate)

3. FATHER'S NAME (as in candidate's class X marksheet or equivalent certificate)

5. GENDER

4. PHYSICAL STANDARD
Height

6. CATEGORY

7. NATIONALITY
Indian

(Please tick)

(Please tick)

Weight

Male
kg.

cm

Female

GEN

ST

SC

OBC

(Please tick)

Others

If Other
Specify

8. PROGRAM APPLYING FOR (You may be offered option-2 in case you do not qualify for option-1.

9. DATE OF BIRTH

Choose option-2 from list of programs under same eligibility. Refer Admission Prospectus - 2016 for program code)
Program Code
Program Code

(as in candidate's class X marksheet or equivalent certificate)

Option-1

1D

Option-2

10. ADMISSION CATEGORY (Refer admission prospectus - 2016 for Fee and Category specification)
(Please tick)

Non-Sponsored

Sponsored

Company Sponsored

12. PREQUALIFYING TEST (If applicable) (Please tick) MAT

CAT

Date of Test

Form No.

NRI

Yes

2
M

1Y

JEE

13. PASSPORT
(Applicable for
No.

Validity

Non AC
Amity Test

NATA

Dubai Campus)

Require Student VISA?

Yes

No

14. Contact Numbers


Country Code

Mobile Number

Landline phone number with STD(area) code

15. MANDATORY E-MAIL ADDRESS (Only in Capital Letters)

16. Write your complete Correspondence address including


your name in English in Capital Letters with Black Pen.
(For any communication related to your admission)

Address :

(Within the Box Only)

17. SIGNATURE OF THE CANDIDATE


(Within the Box only)

City :

18. PHOTOGRAPH

- Write application Form no. at the back of a


recent color Photograph (size:3.5x4.5cm)
- Paste photograph (do not staple).
- Do Not Attest

Name :

State :

Country :
Postal Code (PIN/ZIP) :

2Y

Score

7Y

(Please tick)

Percentile

Roll Number (or) ID

9Y

If "Yes" AC

No
XAT

NMAT

0M

11. HOSTEL ACCOMMODATION

Foreign

GMAT

D6

Application Form No.

54487

19. EDUCATIONAL QUALIFICATIONS


It is mandatory to fill all details of educational qualification (as applicable) from class X onwards till last completed semester/year. if the system of marking of your school/college is on grading
pattern, convert grade into marks as applicable and fill in the respective columns. In absence of complete information, form will be rejected.

CLASS XII

CLASS X
CBSE

ICSE

NIOS

Passing Year

OTHERS

CBSE

ISC

NIOS

Passing Year

OTHERS

Board

Board
(Please tick)

(Please tick)

Aggregate percentage of all subjects on


class X marksheet (enclose photocopy)

Medium of instruction (Please tick)

English

Hindi

Others

Board Roll No.

Board Roll No.

CLASS XII BOARD RESULT DETAILS (Provide details of minimum 5 academic subjects as in class XII marksheet)
SUBJECT NAME

MARKS OBTAINED

MAXIMUM MARKS

GRADE / POINTS in %
(FOR INT. BOARDS)

XII School Name

City

Pin / Zip Code

XII Board Name (Recognised Board) For list of recognized Indian Boards refer www.cobse.org

GRADUATION DETAILS

Medium of instruction (Please tick) English


Branch/Subject of specialization (if any)

Name of Degree

Semester/Year wise Marks

Duration of Degree
Years

SEMESTER/
YEAR

Months
1

Scheme of Examination (Please tick)


Semester

Annual

Discipline (Please tick)


Arts

2
3
4

Commerce
Engineering
Management

5
6

Science
Others

Mode of study

(Please tick)

Full Time

7
8
9

Part Time
Correspondence

10

Hindi

Others

(please fill either MARKS or GPA information based on the evaluation system)

MARKS
OBTAINED

MAXIMUM
MARKS

/
/
/
/
/
/
/
/
/
/
2

SGPA*/CGPA*
OBTAINED

NO OF BACK PAPER(S)
(If not cleared till date)

.
.
.
.
.
.
.
.
.
.
*Scale used in case of SGPA/CGPA

Application Form No.

54487
Graduation - Years
Attended From

University
Enrollment
No.

To :

Name of the University

Name of the College

City

Pin / Zip Code

POST GRADUATION DETAILS

Medium of instruction

(Please tick)
English
Branch/Subject of specialization (if any)

Name of Degree

Years
Attended From

To :

Hindi

Others

University
Enrollment No.

Name of the University

City

Semester/Year wise Marks

Months

Annual
4

Discipline (Please tick)


5

Arts

Commerce

Engineering

Management

Science

Others

Mode of Study

(Please tick) Full Time

SGPA*/CGPA*
OBTAINED

/
/
/
/
/
/

Scheme of Examination (Please tick)


Semester

MAXIMUM
MARKS

Duration of Degree
Years

(please fill either MARKS or GPA information based on the evaluation system)

MARKS
OBTAINED

SEMESTER/
YEAR

Part Time

NO OF BACK PAPER(S)
(If not cleared till date)

.
.
.
.
.
.
*Scale used in case of SGPA/CGPA

Correspondence

20. AWARDS / ACHIEVEMENTS (if any, latest two) Proof will be verified on the day of selection
For what

Received when

Name

21. EMPLOYMENT HISTORY (if applicable) Work Experience?


(Please tick) Yes
Last Organisation Name

if "Yes", total years Years


of work experience

No

Months

Last Designation

Date From

Date To

22. FAMILY INFORMATION

Country Code

Last salary drawn per month in INR

Part-Time

Parent Email ID (only in capital letters)

Father's Mobile No.

Country Code

Full-Time

Mother's Mobile No.

Application Form No.

54487
Age

Organisation

Profession

Qualification

Designation

Father
Mother

23. PREVIOUSLY APPLIED

Have you previously applied to Amity ? (Please tick)

Yes

No

If Yes

Year

Previous Form No. :

24. FAMILY AT AMITY (if applicable)

Yes

Were you Selected ? (Please tick)

Employee

Association of any family member with Amity (Please tick)

Student

No

Alumni

Name of the Family Member

Institute Name

Program Name (if Student / Alumni) / Designation (If Employee)

Year From
Duration

Year To

Your relationship with associated Amitian? (Please tick)

Grandparent

Parent

Spouse

Sibling

25. CORRESPONDENCE ADDRESS (same as point 16)


Address

City :

PIN / ZIP
Code :

State :

Country

26. WRITE YOUR COMPLETE PERMANENT ADDRESS (if different from correspondence address)
Address :
City :

PIN / ZIP
Code :

State :

Country

27. Do you suffer from any chronic ailment or disability :

Yes

No

If "Yes" give details:


28. Have you ever been suspended, dismissed or put on academic probation or warning at any school or college?
If "Yes" please explain on a separate sheet of paper.

Yes

No

29. Details of Payment of Form


BY DEMAND DRAFT

DD No.

Date : D

MICR No.

M M

(9digit number next to DD No. on the Demand Draft)

THROUGH ONLINE

Receipt No.

Online Transaction No.

Date :

30. SIGNATURE
I hearby certify that the information given in the Application (all relevant Forms) is complete and accurate.
I understand and agree that misrepresentation or omission of facts will justify the denial of admission, the cancellation of admission, or expulsion.
I have read, understood and do hereby consent to the Terms & Conditions for Admission as mentioned in Admission Prospectus 2016.
I have enclosed photo copy of class X marksheet or equivalent certificate.

Date :

Signature :

For
office use
only

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