Professional Documents
Culture Documents
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
Lucknow Campus
Gwalior Campus
Jaipur Campus
Mumbai Campus
Raipur Campus
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.
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
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)
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
Option-1
1D
Option-2
10. ADMISSION CATEGORY (Refer admission prospectus - 2016 for Fee and Category specification)
(Please tick)
Non-Sponsored
Sponsored
Company Sponsored
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)
Yes
No
Mobile Number
Address :
City :
18. PHOTOGRAPH
Name :
State :
Country :
Postal Code (PIN/ZIP) :
2Y
Score
7Y
(Please tick)
Percentile
9Y
If "Yes" AC
No
XAT
NMAT
0M
Foreign
GMAT
D6
54487
CLASS XII
CLASS X
CBSE
ICSE
NIOS
Passing Year
OTHERS
CBSE
ISC
NIOS
Passing Year
OTHERS
Board
Board
(Please tick)
(Please tick)
English
Hindi
Others
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)
City
XII Board Name (Recognised Board) For list of recognized Indian Boards refer www.cobse.org
GRADUATION DETAILS
Name of Degree
Duration of Degree
Years
SEMESTER/
YEAR
Months
1
Annual
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
54487
Graduation - Years
Attended From
University
Enrollment
No.
To :
City
Medium of instruction
(Please tick)
English
Branch/Subject of specialization (if any)
Name of Degree
Years
Attended From
To :
Hindi
Others
University
Enrollment No.
City
Months
Annual
4
Arts
Commerce
Engineering
Management
Science
Others
Mode of Study
SGPA*/CGPA*
OBTAINED
/
/
/
/
/
/
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
No
Months
Last Designation
Date From
Date To
Country Code
Part-Time
Country Code
Full-Time
54487
Age
Organisation
Profession
Qualification
Designation
Father
Mother
Yes
No
If Yes
Year
Yes
Employee
Student
No
Alumni
Institute Name
Year From
Duration
Year To
Grandparent
Parent
Spouse
Sibling
City :
PIN / ZIP
Code :
State :
Country
26. WRITE YOUR COMPLETE PERMANENT ADDRESS (if different from correspondence address)
Address :
City :
PIN / ZIP
Code :
State :
Country
Yes
No
Yes
No
DD No.
Date : D
MICR No.
M M
THROUGH ONLINE
Receipt 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