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Counselee Details

All the mentees / counselee are kindly requested to fill up the form given below.

Select Course

• MBA (Master of Business Administration)
• MAM (Master in Applied Management)

Counselor *

• Dr. Jitesh Parmar
• Mrs. Apurva Jain
• Mr. Mulchand Sen

Enrolment No.

FULL NAME YOUR NAME FATHER'S NAME SURNAME

Your Mobile Number

Your Address (Permanent)

Your Address (Current / for communication / hostel / PG) If any

I am commuting from___________.

• Home
• Hostel
• PG Location

Date of birth Example - 15 June 1990

Your father's name

Father's mobile No.

Your mother's name

Mother's mobile number / Landline number

Mode of transportation to college.

• Bus
• Own vehicle
• With member from my family
• By taking lift
• College bus
• Other

Your email ID

SSC percentage

HSC percentage

Graduation stream If any

• Arts
• Commerce
• Science

Graduation percentage If any

Your special achievement.

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