SIES College of Management Studies

Sri Chandrasekarendra Saraswathi Vidyapuram

Plot 1E, Sector V, Nerul, Navi Mumbai 400 706
Tel: (022) 27708376 / 77 Fax: 022-27708379
Admn Mobile Nos: 09324364263 / 09324892434
Email: admissions@siescoms.edu
Website: www.siescoms.edu
Face book link:www.facebook.com/SIESCOMS

APPLICATION FORM

FOR ADMISSION TO POST GRADUATE DIPLOMA IN MANAGEMENT (PGDM) PROGRAMS (201315)

(To be filled by the SIESCOMS Admission Office)
PGDM Application No :
GD/PI :
Center

Minority /
General

Program
Preference

Affix Photograph

GDPI No.

PLEASE READ THE INSTRUCTIONS CAREFULLY BEFORE COMPLETING THE FORM

A. APPLICATION FORM FOR ADMISSION TO (Please put a tick in the box)

Indicate preference if you are applying for more than one program(put 1-1st preference, 2-2nd preference, 3-3rd
preference)

1.PGDM (Post Graduate Diploma in Management )

Tick

Preference

2.PGDM (Pharmaceutical Management)

Tick

Preference

3.PGDM (Biotech Management)

Tick

Preference

General

Category (please tick)

* Minority

B. PREFERRED CENTRE OF ADMISSION PROCESS (Please put the tick in the appropriate box)

(a) Mumbai

(b) New Delhi

(c) Bhopal

(d) Bengaluru

C. STUDENT CONTACT INFORMATION

1. Full name (block letters)
(as per degree mark sheet)

2. Date of Birth (MONTH /DAY /YEAR) :

3. Gender

4. Marital Status

5. Nationality

6. Religion

7. Mother Tongue

8. Caste

9. Tel & Mobile Number

10. Email

*Maharashtra domiciled South Indian Language

11.Local Residential Address for

Correspondence

Telephone & Mobile No.

12.Permanent Address including

Telephone No.
(If different from above)

13. a. Fathers name

b. Occupation

c. Contact no.

d. Email ID

14. a. Mothers name

b. Occupation

c. Contact no.

d. Email ID

15. Family income per annum

(in lakhs)

D. ACADEMIC QUALIFICATIONS
Name of the School/College

Board

Month and Year of Passing

Percentage of Marks

Std X
Std XII
N.B.: Please provide the attested photocopies of the above mentioned certificates along with the application form and the original of the same should
be submitted at the time of securing admission.

Bachelors Degree
Name of the Degree
Name of Institute/College
Name of University
Month and Year of Passing*
Marks obtained in Graduation
(Total marks obtained/Out of
maximum marks)
eg: 350/500

2nd Year
1st Year
nd
rd
(1 & II sem) (III & IV th sem)
st

3rd Year
(V & VI th sem)
th

4th Year
5th Year
th
(VII & VIII sem)
th

Grand Total (Total marks

**
obtained/Out of maximum marks)
* If appearing in 2013 for final examination/semester, mention APPEARING
# Fill in the score/appearing/ not applicable
** Students who have completed their graduation should give the aggregate marks obtained in all the years/semesters.
Students, who are appearing, should give the aggregate marks obtained in previous years/semesters.

Other Courses
Sr. No

Name of Degree/Course

Class and Percentage of Marks

Name of the Institute/ University

N.B.: Please provide the attested photocopies of the above mentioned courses along with the application form and the original of the same should be
submitted at the time of securing admission.

Composite Score(s) of Competitive Tests

Sr.No.

Competitive Test

1.

CAT

2.

CMAT

3.

MAT

4.

ATMA

Passing Month & Year

Composite Marks Obtained

Maximum Marks

N.B.: Please provide the attested photocopies of the above mentioned competitive score(s ) sheets along with the application form and the original of
the same should be submitted at the time of securing admission. Please do not provide percentile marks.

E. WORK EXPERIENCE
Name of the Organization

Tenure
From

To

No. of Months
Worked

N.B.: Please provide the attested photocopies of the work experience certificates along with the application form.

Position Held

ENCLOSURES

(i) Proof of age (Date of birth certificate / SSC certificate /

School leaving certificate)

- Attested photocopy

(ii)

Marks sheet & passing certificate of SSC, HSC & Degree

examination passed. Students awaiting final year result
should submit marksheet of all earlier years.

- Attested photocopy

(iii)

Score card of competitive tests

- Attested photocopy

(iv)

Work experience certificate

- Attested photocopy

(v)

Photo (One additional copy)

(vi)

Details of demand draft for application form.

Dated ________________

Amount ______________________

Bank ________________________________Branch ___________________

DD No. _______________

(vii) If you are applying under linguistic minority category, please enclose:
(i) Domicile Certificate of Maharashtra
(ii) Declaration of belonging to linguistic minority on a Rs.100/-stamp paper (Notarized)
I declare that all the particulars provided by me above are true.

Signature: __________________________
Place: _____________________________
Date: _____________________________
The completed Application Form along with the draft favoring SIES College of Management Studies,
payable at Mumbai, for the amount of application fee, is to be submitted at the institute address on working
days, from 10.00 a.m. to 4.00 p.m.
The forms can also be submitted by post/ courier so as to reach the SIESCOMS office before the last date.
These applicants will receive the Admit Card by courier/ post.

Please Note: All disputes in Mumbai Jurisdiction

SIES College of Management Studies

Sri Chandrasekarendra Saraswathi Vidyapuram
Plot 1E, Sector V, Nerul, Navi Mumbai 400 706
Tel: (022) 27708376 / 77 Fax: 022-27708379
Admn Mobile Nos: 09324364263 / 09324892434
Email: admissions@siescoms.edu
Website: www.siescoms.edu
Face book link:www.facebook.com/SIESCOMS

ADMIT CARD

FOR ADMISSION TO POST GRADUATE DIPLOMA IN MANAGEMENT (PGDM) PROGRAMS (201315)

(To be submitted along with the Application Form)

Post Graduate Diploma in Management (PGDM 2013-15)

Post Graduate Diploma in Management (PGDM Pharmaceutical Management 2013-15)
Post Graduate Diploma in Management (PGDM Bio-tech Management 2013-15)

Name:

Affix
Photograph

PGDM Application No:

GD/PI:
Center

Minority /
General

Admission Process
Date:
Time:
Center allotted:

Program
Preference

GDPI No.

Signature and Seal of the Office

SIES College of Management Studies

Sri Chandrasekarendra Saraswathi Vidyapuram
Plot 1E, Sector V, Nerul, Navi Mumbai 400 706
Tel: (022) 27708376 / 77 Fax: 022-27708379
Admn Mobile Nos: 09324364263 / 09324892434
Email: admissions@siescoms.edu
Website: www.siescoms.edu
Face book link:www.facebook.com/SIESCOMS

BRIEF STUDENT PROFILE

FOR ADMISSION TO POST GRADUATE DIPLOMA IN MANAGEMENT (PGDM) PROGRAMS (201315)

(It is mandatory to bring this page along with you without fail, at the time of your GD/PI)

Name:

PGDM Application No:

GD/PI No:

Date:

(i) Mention your hobbies / interests

-------------------------------------------------------------------------------------------------------------------------------------------------------- --------------------------------------------------------------------------------------------------------------------------------------------------------

(ii) Narrate your academic achievements in brief

------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------(iii) Describe the extra-curricular activities you have participated and achievements therein
-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

--------------------------------------------------------------------------------------------------------------------------------------------------------(iv) State any three of your strengths and weaknesses

Strengths:
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ Weaknesses:
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------(v) Mention in brief any leadership activity you have been involved in
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------(vi) State, in not more than 2 lines, your reasons to join the program
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