New Delhi – 110025

Application Form for Admission to MBA Programme Affix a recent passport

(DISTANCE MODE) 2019 – 2020 size self-attested
colour photograph

Roll No.
(To be filled in by the office)
(To be filled in capital letters using Blue/Black ball pen only)

1. Name of the Learner CDOL, Jamia Millia Islamia

Support Centre
(See Link V in Prospectus)

2. Learner Support JSC-DL-01 3. Applicant’s

Centre Code Aadhaar No.
(See Link V in Prospectus)

4. Applicant’s Name
(In Capital Letters)

5. Father’s Name

6. Mother’s Name

7. Date of Birth 8. Gender

(DD/MM/YYY)

9. Applicant’s Category
(See Category Code overleaf )

10. State of Domicile 11. Nationality

12. Mobile No. 13. Alternate Mobile No.

14. Email ID

15. Bank Details A/c No. Bank Branch IFSC Code

(In case of Refund of Fee)

16. Mailing Address: 17. Permanent Address:

……………………………………………………… ………………………………………………………

……………………………………………………… ………………………………………………………

……………………………………………………… ………………………………………………………

……………………………………………………… ………………………………………………………

……………………………………………………… ………………………………………………………
 X

XII

Bachelors

Masters

Others

DECLARATION BY APPLICANT

I SOLEMNLY UNDERTAKE to accept and abide by the rules of the Jamia Millia Islamia and all the decisions of the Admission Committee and
other appropriate University bodies in regard to my admission.

I SOLEMNLY AFFIRM that I have never been convicted by a court of law nor rusticated/expelled from any educational institution /nor
disqualified/debarred from any examination.

I will accept the cancellation/ forfeiture of my candidature in case any information supplied by me in this form is found to be incorrect at the
time of admission or thereafter.

Signature of Father/Guardian Date Signature of Applicant

DD No. _______________________ Date ________________ Drawn on _________________________________________ Amount.______________

Note: The Application Form should be submitted along with Demand Draft of Rs. 700/- in favour of Jamia Millia Islamia,
payable at New Delhi.
Transgender Candidates: No admission application form fee or programme fee will be charged from transgender candidate

CATEGORY CODE
General (G) Muslim General (MG)
Muslim Women (MW) Muslim OBC (MO)
Muslim Scheduled Tribe (MST) Persons with Disability (PD)
Scheduled Tribe (ST) Scheduled Caste (SC)
Transgender (T)
Once opted for, category change is not permissible.
 Master in Business Administration (MBA) (Distance Mode) 2019-20
ADMIT CARD

Centre for Distance and Open Learning

JAMIA MILLIA ISLAMIA Entrance Test Roll No.
Maulana Mohammed Ali Jauhar Marg, New Delhi-110025 (To be filled in by the office)

Entrance Test Centre

(To be filled in by the office)

Entrance Test Centre Code: Affix your recent

self attested coloured
photograph
(To be filled in by the office)
(Size 2.0 x 1.5)
It should be pasted
Applicant’s Name (in Capital Letters) : ………………………………….……….…… with gum

Applicant’s Father’s Name : …………………………………..……………

Applicant’s Mother’s Name : …………………………………..……………

…………………………… ………….…………………
Signature of Applicant Signature of Invigilator

Programme Coordinator

INSTRUCTIONS TO THE CANDIDATE

1. The Examination Hall will open 15 minutes before the commencement of entrance test. No candidate
will be permitted to enter the Hall 30 minutes after the commencement of the test.
2. Candidate must show on demand his/her Admit Card during the test. The invigilators will check and
sign on the Admit Card of the candidate to satisfy themselves about the Identity of each candidate.
3. The candidate should carry his/her valid Photo Id Proof for verification.
4. The invigilator will sign on the question booklet after verification of the Candidates.
5. Candidate must not take any book or paper into the Examination Hall except the Admit Card, ID Proof,
blue or black ball pen required for use during the test.
6. Candidate must keep perfect silence during the test and must not indulge in any conversation or
gesticulation.
7. Violation of any of these instructions or use of any unfair means or copying will lead to cancellation of
the admission test of the candidate on the spot by the superintendent of the Examination Centre.
8. Candidate must hand over the answer sheet to the invigilator before leaving the Examination Hall.
9. Calculator /Cell phone is not allowed in the examination hall.
10. It will be advisable for the candidate to visit his/her examination centre at least a day earlier to know its
exact location.
11. The candidate should keep his/her Admit Card in safe custody. It may be required not only for the
Entrance Test but also at the time of Admission.
 Admission Entrance Test
Master in Business Administration (MBA) (Distance Mode) 2019-20
Student Copy
ADMIT CARD

Centre for Distance and Open Learning

JAMIA MILLIA ISLAMIA Entrance Test Roll No.
Maulana Mohammed Ali Jauhar Marg, New Delhi-110025 (To be filled in by the office)

Entrance Test Centre

(To be filled in by the office)

Entrance Test Centre Code: Affix your recent

self attested coloured
photograph
(To be filled in by the office)
(Size 2.0 x 1.5)
It should be pasted
Applicant’s Name (in Capital Letters) : ………………………………….……….…… with gum

Applicant’s Father’s Name : …………………………………..……………

Applicant’s Mother’s Name : …………………………………..……………

…………………………… ………….…………………
Signature of Applicant Signature of Invigilator

Programme Coordinator

INSTRUCTIONS TO THE CANDIDATE

1. The Examination Hall will open 15 minutes before the commencement of entrance test. No candidate
will be permitted to enter the Hall 30 minutes after the commencement of the test.
2. Candidate must show on demand his/her Admit Card during the test. The invigilators will check and
sign on the Admit Card of the candidate to satisfy themselves about the Identity of each candidate.
3. The candidate should carry his/her valid Photo Id Proof for verification.
4. The invigilator will sign on the question booklet after verification of the Candidates.
5. Candidate must not take any book or paper into the Examination Hall except the Admit Card, ID Proof,
blue or black ball pen required for use during the test.
6. Candidate must keep perfect silence during the test and must not indulge in any conversation or
gesticulation.
7. Violation of any of these instructions or use of any unfair means or copying will lead to cancellation of
the admission test of the candidate on the spot by the superintendent of the Examination Centre.
8. Candidate must hand over the answer sheet to the invigilator before leaving the Examination Hall.
9. Calculator /Cell phone is not allowed in the examination hall.
10. It will be advisable for the candidate to visit his/her examination centre at least a day earlier to know its
exact location.
11. The candidate should keep his/her Admit Card in safe custody. It may be required not only for the
Entrance Test but also at the time of Admission.