CENTRE FOR RESEARCH STUDIES

APPLICATION FORM FOR ADMISSION TO FELLOW PROGRAMME IN MANAGEMENT (FPM)/

EXECUTIVE FELLOW PROGRAMME IN MANAGEMENT (EFPM)
(Incomplete forms will not be considered)

Form No: __________

Recent
Coloured
Passport Size
Photograph

Registration No. (for office use only) __________________________________________________

Date of Admission (for office use only)_________________________________________________

-----------------------------------------------------------------------------------------------------------------Abhranil Gupta
Full Name: ____________________________________________________________________________________________
Somnath Gupta
Fathers Name: _________________________________________________________________________________________
Banasri Gupta
Mothers Name: ________________________________________________________________________________________
July 1984
INDIAN
Unmarried
11 /____/__________
Date of Birth: ______
Married/ Unmarried: ___________________
Nationality: ________________________
16/1 Tarak Chatterjee Lane, Kolkata: 700005
Correspondence Address: ________________________________________________________________________________
West Bengal, India
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________

+91 9831358784
+91 33 25301767
Not Applicable
Phone No.: (off.) _________________________
(Res./Mobile) ______________________Fax
No.: _______________________
abhranil.gupta84@gmail.com
E-mail: _______________________________________________________________________________________________
A. Academic Record (Attach attested photocopies)
Examination
Name of the
Institution
Secondary(X)

ICSE

Senior Secondary(XII)

ISC
Graduate Degree
Bachelor of Technology
Post Graduate Degree
Master of Technology
Professional Degree

Sacred Heart High

School
St. Thomas High
School, Howrah

Board/University

Year of
Passing

Marks
(%)/
CGPA

Subject(s)/ Specialization

CISCE

2000

67.8%

English, Bengali, Physics, Chemistry

Mathematics, Computer Sc, History,
Geography

CISCE

2003

61.0%

English, Bengali, Physics, Chemistry

Mathematics, Computer Sc,

Gurunanak Inst. of
Technology

West Bengal University

of Technology

2007

7.68/10

Electrical Engineering

School of Management

West Bengal University

of Technology

2010

7.59/10

Industrial Engineering &

Management

Any Other

B. Academic/Professional Awards/ Medals/ Prizes/ Scholarships/ Certificates/ Honors etc.

360 Faculty Development Program (iLEAD, Brunnel and Tennesse State University)
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________

C. Employed/ Unemployed (Please Tick)

Management Consultant With Auctus Solutions

(If employed, attach details of Institution(s)/Organization(s) served and No objection certificate from the employer)
Part Time : 20 Months
Nil
In Case of Teachers: Teaching Experience of UG_________________________PG___________________________________
D. Research Papers/Articles published
Prasun Das and Abhranil Gupta: Molding a solution; Six Sigma Forum Magazine; American Society of Quality: Vol. 11 No. 4 Issue August 2012
1. ________________________________________________________________________________________________________
2. _________________________________________________________________________________________________________

E. Research Conferences /Seminar Attended

Not Applicable
1. ________________________________________________________________________________________________________
2. _________________________________________________________________________________________________________
F. Area of Research Interest
Operations Research & System Analysis
1. ____________________________________________________________________________________________________
Operations Research
2. ________________________________________________________________________________________________________
G. Please write a brief note on the proposed area of research that you would like to take-up for in-depth study and reasons for
your choice
H. Describe briefly how do you consider this programme to help you in achieving your career plans?
I. Give 3 reasons that you consider should weigh in your favour for admission
J.

Declaration
a)

I declare that all the information given by me in this application form is correct to the best of my knowledge and belief and I
understand that false or incomplete information would cause invalidation of the application.

b)

I shall abide by the decision of BIMTECH in all matters pertaining to admission and administration of the program. The
Institutes decision shall be final and binding on me.

c)

I shall abide by the rules and regulations of BIMTECH, if selected.

d)

For all legal actions, suits and proceedings, the jurisdiction of a court of law shall be deemed to lie exclusively at the place at
which the institution is situated and at no other court or place.

e)

I understand the contents of this form and particularly this declaration being made here.

Place:

Date:
Signature of the Applicant
* Attach separate sheet where needed