Dear Applicant,

You are important to us.

We have exceptionally high standards for the talent that we take in to our programmes. Superior leadership
qualities, communication and interpersonal skills, commitment, problem-solving ability, Value driven mindset,
professionalism, flexibility, motivation and sharp intellectual curiosity are expected.

PLEASE READ THE INSTRUCTIONS IN THE APPLICATION FORM & ADMISSION PROSPECTUS - 2010,
CAREFULLY BEFORE YOU BEGIN TO FILL YOUR APPLICATION. THE APPLICATION FORM SHALL BE
FILLED IN YOUR OWN CLEAR AND LEGIBLE HANDWRITING AND THE UNDERTAKING IS TO BE SIGNED
BY YOU ONLY.

This Application form is valid for the Amity University - Uttar Pradesh, Campuses in Noida and Lucknow
& Amity University - Rajasthan, Campus in Jaipur.

• For all details relating to Eligibility, Fee structure and Procedure for Admission to all the programmes, kindly refer
to the Admission Prospectus - 2010. (www.amity.edu/admission).

• Duly filled in Application Form together with self attested copies of all mark sheets from class Xth onwards till
last completed semester / year should be submitted / sent to the respective campus you are applying to :

Noida Campus Lucknow Campus Jaipur Campus

Amity Admission Office Amity Admission Office Amity Admission Office
Sector - 125 Viraj Khand-5, Gomti Nagar Scheme Amity House, 14 Gopal Bari
Noida - 201 303 (Adj. New Delhi) Lucknow - 226 010 (UP) Ajmer Road, Jaipur-302006 (Rajasthan)
Admission Helpline Admission Helpline Admission Helpline
Tel : 0120-2445252 Tel : 1800-1800-999, 0522-6525676 Tel : 1800-1800-111, 0141-2372489

• Visit www.amity.edu/admission for all information relating to your application & admission after submission of
application form

• Qualifying candidates can select their date for On Campus Admission Process at www.amity.edu/admission.
It is your responsibility to check the website for selection of date and appear in the Admission Process
accordingly. No separate communication will be sent in this regard.

• You are advised to keep a photocopy of the complete application form.

• Incorrectly filled, incomplete, unsigned forms & forms recieved after due date will be rejected.

• Forms once rejected will not be reconsidered & form cost will not be refunded.

• You can not apply more than once for the same programme in one admission year.

• Mark sheets of Board / University submited with the Application Form only will be considered for all
procedure related to admission.

• Amity does not take any responsibility for delay or loss of the material in post / transit.

We do not accept any donations for admission. Merit is the only criteria.
Any instances found, even at a later date, will lead to cancellation of admission.
 AMITY UNIVERSITY
Application Form Number APPLICATION FORM-2010
(DOWNLOADED)
Form No : 1590940 INSTRUCTIONS
Password : 74wa4x 1. Please read the instructions in the Admission Prospectus-2010 before filling up this form.
2. Use BLACK BALL POINT PEN in boxes using English capital letters or English numerals.
3. Do not make any stray marks on this sheet.
4. Do not staple, pin, wrinkle, scribble, tear, wet or fold this sheet.
5. Write in CAPITAL LETTERS only within the box without touching the lines as shown in the Sample below.
1590940 0 1 2 3 4 5 6 7 8 9 A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

1. NAME OF THE CANDIDATE (as in high school or equivalent certificate)

P R A J E E T D H A G A T
2. FATHER'S NAME (as in high school or equivalent certificate)

3. MOTHER'S NAME (as in high school or equivalent certificate)

4. PHYSICAL STANDARD 5. GENDER 6. CATEGORY 7. NATIONALITY

Indian Others
Height Weight Male GEN ST
If Other please specify
ft. inch. kg. Female SC OBC

8. PROGRAM APPLYING FOR (You may be offered option 2 in case you do not qualify for option 1 9. DATE OF BIRTH
Choose option 2 from list of programs under same eligibility.)
Program Code Program Code Date Month Year

Option -1 1 0 0 2 2 Option -2 2 7 1 2 1 9 8 6
(Refer Admission Prospectus-2010 for program code)

10. ADMISSION CATEGORY (Refer admission prospectus for Fee) 11. WILL YOU BE FINANCING YOUR
EDUCATION THROUGH Yes
Non-Sponsored Sponsored Company Sponsored NRI Foreign EDUCATION LOAN No

12. HOSTEL ACCOMMODATION 14. CONTACT NUMBERS

AC STD Code Telephone No.
Yes
If "YES"
No Non AC

13. PREQUALIFYING TEST CAT

(Only for MBA Programs) Country Code Mobile No.
(Enclose copy of Score Card) MAT

GMAT
15. MANDATORY E-MAIL ADDRESS (Only in Capital Letters)

16. Write your complete Correspondence address including

your name in English in Capital Letters with Black Pen.
(For all communication including letter of admission)
18. PHOTOGRAPH

Name : Write Application form number &

Address : Name at the back of a
recent colour Photograph
17. SIGNATURE OF THE CANDIDATE
(Within the Box only) (size : 3.5x4.5 Cm)
& paste (do not staple).
(Within the Box Only)
City : State :

PIN : Do Not Attest

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19. EDUCATIONAL QUALIFICATIONS
It is mandatory to attach photocopies of all mark sheets (front & back side) with the form, from class X onwards till last completed semester/year. If the system of marking
of your school/college is on grading pattern, convert grade into marks as applicable and attach proof of conversion. In absence of any mark sheet your form will be rejected.

BOARD PASSING YEAR MARKS OBTAINED MAXIMUM MARKS

Class
CBSE ICSE NIOS OTHERS

XII

CLASS XII SUBJECT MARKS DETAILS

Subject Code :- Physics - 01, Chemistry - 02, Biology/Biotech - 03, Mathematics - 04, English - 05, All Other Subjects - 06

SUBJECT CODE SUBJECT NAME MARKS OBTAINED MAXIMUM MARKS

Name of School :

City : Board Roll No.

GRADUATION DETAILS
Name of Diploma / Degree

University
Years Attended From: To: Enrollment
No.
Duration of Degree Semester / Year Wise Marks
SEMESTER MARKS MAXIMUM YEAR MARKS MAXIMUM
Year Months OBTAINED MARKS OBTAINED MARKS

1
1
DISCIPLINE
2
COMMERCE
3
ENGINEERING 2
4
MANAGEMENT
5
SCIENCE
3
OTHERS 6

MODE OF STUDY 7
4
FULL TIME
8

PART TIME
9
5
CORRESPONDENCE
10

Do you have any back paper which you have not cleared till last semester/annual exam? If yes, how many?

2
 Application Form No.

Name of College

City

Name of University

POST GRADUATION DETAILS

Name of Degree / Duration of Years Marks Maximum
University
Diploma Program Attended Obtained Marks
Yr 1
Fm :_________
Yr 2

Yr 3
To :__________
Total
20. AWARDS / ACHIEVEMENTS if any (Latest two with proof) 21. PREVIOUSLY APPLIED:
Name Received when For what Have you previously applied
to Amity? Yes No

Program

Year

Were you Selected? Yes No

22. PROFESSIONAL COURSES

Institution Course Full / Part Time Dates Attended Qualification Given

23. EMPLOYMENT HISTORY (if applicable) attach Experience Certificate

Work Experience? Details of current / last job

Yes
Organisation Name :
No
Address of Organisation :
If "Yes", total years of work
Years Months
City : Tel. :

Last Designation: Last Salary Drawn:

Full-Time

Dates : From To Part-Time

24. ADDITIONAL INFORMATION

1.

2.

25. FAMILY INFORMATION

Age Qualification Profession Organisation Designation
Father
Mother

EMAIL ADDRESS OF PARENTS (Only in Capital Letters)

3
26. FAMILY AT AMITY

Have any of your family members studied / worked with Amity? Yes No
If, studied, Name Program Year

If, worked, Name Institution Year

What is the relation to you

27. CORRESPONDENCE ADDRESS (Same as point 16)

Address :

City :

State : Pin Code :

28. WRITE YOUR COMPLETE PERMANENT ADDRESS (If different from correspondence address)

Address :

City :

State : Pin Code :

Do you suffer from any Chronic ailment : Yes No If yes give details :

Have you ever been suspended, dismissed or put on academic probation or warning at any school or college ?
If "Yes" please explain on a separate sheet of paper. Yes No

29. ENCLOSURES CHECK LIST (Incomplete forms will be rejected)

Listed below is each item which must accompany this form. To ensure prompt and accurate processing of your application,
check each item you are enclosing with the application.

Photograph Self Attested Photocopy of Educational Mark Sheets

Photocopy of Pre-qualifying Test Score Card Others (Please specify)
(Only for MBA Programs)
DETAILS OF PAYMENT OF FORM
Online Transaction No. Date :
Cash Receipt No. DD No. Bank Date :

30. SIGNATURE

I hereby certify that the information given in the Application (all relevant Forms) is complete and accurate.
I understand and agree that misrepresentation or omission of facts will justify the denial of admission, the cancellation of
admission, or expulsion.
I have read and do hereby consent to the Terms & Conditions for Admission as mentioned in Admission Prospectus 2010.

Signature : Date :

4
 TERMS AND CONDITIONS FOR ADMISSION

1. Non-Liability : Prospectus / Application Form and all other Admission Correspondence will
be sent by Post / Courier. Amity is not responsible for Postal / Courier delays or loss in transit.

2. Non-refund of fees : All fees once paid are not refundable for any reason whatsoever.
Only Security Deposit will be refunded after making necessary adjustments as required.

3.1 Cancellation of Admission : Amity reserves its right to cancel the admission of successful
candidate under any of the following circumstances :
(a) If the fees is not deposited by the stipulated date.
(b) If the candidate does not join the particular programme by the stipulated date even
though the Fee has been deposited.
(c) If the candidate fails to furnish the proof of the stipulated minimum qualifications.
(d) If any instance of donation / unfair means is found after admission.
(e) If any of the document(s) submitted by you to Amity University is found to be forged,
fabricated or false during the period of your study, your admission shall be cancelled
immediately and fees shall be forfeited. In case you complete the course and obtain the
degree on the basis of documents which are later found to be forged, fabricated or
false, at any point of time, your degree shall be cancelled/ recalled.

3.2 Provision of Non Refund of Fees under Clause 2 will also apply in cases under Clauses
3.1 (b) and (c).

4. Right of Alteration / Modification :

(a) Amity reserves its right to alter or modify the structure of any of the programs to attain
the objective of excellence.
(b) Amity reserves its right to change the provided Fee Structure.
(c) Amity reserves its right to modify, alter and / or include any other Terms and Conditions
that may be deemed fit in the interest of the Institution.

5. Jurisdiction : Any dispute pertaining to admission, or any matter as a student or alumnus of

Amity shall be subjected to the jurisdiction of the Delhi Court only.

6. Limitation Clause : No dispute shall be raised after the expiry of 30 days from the date on
which the process of admission and / or selection is completed.

7. Agreement Clause : All successful candidates shall be bound by the above mentioned Terms
& Conditions of Amity.