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EPBABI - KOLKATA

Instructions :
1. Complete the form in CAPITAL letters only.
2. This form is a key part of admission process. Complete and accurate response to the items are, therefore, extremely important. Incomplete or false information will make your candidature null and void.
3. In all matters relating to admission, the decision of the Institute will be final and binding on the applicants. No correspondence will be entertained from the applicant regarding his/her non-selection.
4. Please use Internet Explorer 8.0, Mozilla Firefox or Google Chrome
5. Total Fee for entire 3-month course: Rs. 1,25,000/- in one installment or in 2 installments as given below.
i. 1st Installment Rs. 62,500/- (for admission)
ii. 2nd Installment Rs. 62,500/- (within 4 weeks)

 

PERSONAL DATA

Name

Date of Birth

(YYYY-MM-DD)

Address for correspondence

Pin

Email ID

Phone

Mobile

Nationality

Category

Gender

 

  

ACADEMIC QUALIFICATIONS

 

degree

institute/ university

starting year

finishing year

specialization

% of marks/ CGPA

division

Additional Qualifications/ Certifications

 

industry experience (most significant)

Organization

Designation

From (YYYY-MM-DD)

To (YYYY-MM-DD)

Job Responsibilities

 

any other relevant information

DECLARATION

I have carefully read the instructions and agree to abide by the decision of the institute’s authorities regarding my selection for the programme. I certify that the particulars given by me in this form are true to the best of my knowledge and belief.

PLEASE EXAMINE THIS FORM ONCE AGAIN AND MAKE SURE THAT YOU HAVE COMPLETED ALL THE ITEMS