ARHAM MANAGEMENT INSTITUTE, PUNE Manjri Greens Phase III, Solapur Road, Manjri Greens Society, Manjri Bk, Pune, MH 412307 +91-20-26434311 M: +91-9175988373 / +91-9890751822 admissions@amipune.com For Office Use Only Application No. Admission Form MBA + CEP + SAP + MentorshipMBA + CEP This form should be completed in blue or black ink. Please ensure that you submit all relevant documents as indicated in the form. Your application will be automatically refused if any student is found to have furnished false information or suppressed material information and his/her fees will be forfeited. All submitted documents, in ORIGINAL need to be produced at the time of scrutiny/ enrollment for the course. The candidate whose results are yet to be declared should produce the same as soon as the declaration of the results are done or within the time limits provided. For University program, Migration Certificate and Transfer Certificate from the institution/college last attended will be required at the time of enrollment. Upload Photo* Name * Mobile No. Email id* Date of Birth Address * Father's Name Mother's Name Mobile No. Mobile No. I affirm that the information contained within this form is correct and have read all information regarding the course in which I am enrolling and that any further changes in the course/units will not be allowed/entertained. I have read and understood the fees & Charges involved in the course as explained in the relevant section of the Website/Prospectus/Flyer of the institution. I acknowledge that I have a responsibility to appropriately acknowledge the contribution of others in all academic work and to recognize that plagiarism, cheating, collusion, fraud, fabrication or falsifications of data are not acceptable. I agree to pay any additional fee or additional charges from the certifying authorities/universities/and/or the provider Institution(s) arising from my enrolment and academic activity. I agree that the Accommodation Facility provided by the institution is on a contract basis for one academic year and I agree to pay the full annual fees and other applicable charges incase I leave the premises before the completion of my term. I understand that failure to meet my financial obligation to the Institution(s) and/or any provider institution may result in me being precluded from enrolling with any other provider institution. It may also include levy of additional fees/ or restriction of services. I also agree to abide by all the rules regulations in regards to the Campus/ Institution Premises/ Accommodation provided by Institute/Placements as made clear and available to me at the time of any enrollment/ induction in the institution. Applicant's Signature * PART 1 Academic Details 1.1 Please fill up all details of your educational qualifications Academic Qualification Institution/School/College Name Exam Date MM/YY Subjects/ Specialization Board/ Univ % Marks / Grade/Credits Secondary (10th) Higher Sec (12th) Graduation Post Graduation Any Other PART 2 Undertaking 2.1 Undertaking and Declaration by the applicant and the parent/guardian I have read and understood all the rules and regulations of the admission and filled up the application for my admission to the institute. The information furnished by me in the application is true to the best of my knowledge and belief. I understand that giving false or incomplete information may lead to the refusal of my application or cancellation of the admission. I have not been debarred from appearing to any examination held by any government constituted or statutory authority in India or Abroad. I hereby agree to abide by all rules, acts and laws in force by the government/university/institute/society and hereby undertake that so long as I am student of the institute, do nothing inside or outside the institute which may result in disciplinary action against me under the prevailing rules, acts and laws. I fully understand that the competent authority of the Institute where i would be admitted will have full liberty to expel / levy disciplinary action/monetary fine or all as it deems fit on me for my infringement of the rules of conduct, discipline and attendance. I understand to observe full attendance as per the institute rules, failing which, I am aware that my term progression will not be granted. I give permission to the institution to obtain records and information from any educational institution previously attended by me. I hereby agree to complete my financial obligation towards the institute on time failing which the institute will have the right to levy financial penalties / cease my progression or both as it deems fit. 2.2 Date 2.3 Place 2.4 Signature of the applicant 2.5 Name of the parent/guardian 2.6 Signature of the parent/guardian PART 3 Refund Rules & Regulations 3.1 Terms & Conditions for refund of fees in case of cancellation of admissions Request for cancellation of admissions and refund of the fee will be entertained only upon written request on the mail sent to the Head of the Institution on the mail address admissions@amipune.com For requests received within the below mentioned time period, the refund of the fee after applicable deductions will be done accordingly. Please allow a time period of one month for the request to be processed. No refund request will entertained and any refund made once the session has started. Cancellation within 15 days - 50% deduction in fees Cancellation from 16 days to 30 days - 90% deduction in fees Cancellation after 30 days - NO REFUND 3.2 Date 3.3 Place 3.4 Signature of the applicant Pay Admission Fee Now (₹ 1000/-)I Will Decide Later! AMI Pune Account Details Adhyan Management Institute HDFC Bank Current A/c No - 50200077993019 Kondhawe Khurd Branch IFSC - HDFC0000029 Please make the payment of ₹ 1,000/- & Upload the Receipt *