ADMISSION FORM

ASSAM down town University

Guwahati, India. Tel.: +91-20-41034904, +91 9011067684 E-mail: admissions@adtuonline.edu.in

Centre Code Challan No. Reg. No. Date

Affix a passport size Photograph

Title
Name :

Mr. Ms

(Mr/Mrs/Miss/Ms) Date of Birth

Date

First Name

Middle Name Student Category

Surname INDIAN OVERSEAS

Month

Year

Address for Communication Address

City Country E-mail Alternate E-mail

State Telephone

Pin Mobile

Employed

Not

Employed

If Employed, Experience in Years__________

Highest Qualification Achieved till Date:_____________________________________________________________

Instructions :- Please course of your choice. Under Graduate Programs

BBM B.Sc. Information Technology B.Sc. Computer Science

Post Graduate Programs MCA PGDBA + MBA with specialization in

MBA l

in Hospitality Management MBA in Network Infrastructure Management MBA in Design Management MBA in IT Management MBA in Retail Management MBA in Material Management MBA in Risk and Insurance Management MBA in Telecom Management MBA in Infrastructure Management

Fee Details
Please tick ()
Course Name
Bachelor of Business Administration (BBA) Bachelor of Science in Information Technology (BSc. IT) Bachelor of Science in Computer Science (BSc. CompSc) Master of Computer Applications(MCA) PGDBA+MBA MBA in Supply Chain Management MBA in IT Management MBA in Infrastructure Management MBA in Retail Management MBA in Hospitality Management MBA in Material Management MBA in Telecom Management MBA in Design Management MBA in Network & Infrastructure Management

Course Duration 3 3 3 3 2 2 2 2 2 2 2 2 2 2 Rs. 54,000 Rs. 54,000 Rs. 54,000 Rs. 66,000 Rs. 42,000 Rs. 44,000 Rs. 44,000 Rs. 44,000 Rs. 44,000 Rs. 44,000 Rs. 44,000 Rs. 44,000 Rs. 44,000 Rs. 44,000

Total Fees

All payments (DD) should be made in favor of down town Charity Trust payable at Pune.
Mode of Payment: DD
Online Payment Payment in Full Installment

DD No.______________ Amount: _____________ Date: _____________ Bank Name: ________________

In case of installments
P D C Details Cheque No.___________ Amount: _____________ Date: _____________ Bank Name: ________________ Cheque No.___________ Amount: _____________ Date: _____________ Bank Name: ________________ Please attach the following documents when returning this application form: Self attested copy of ID Proof Self attested copy of Highest Qualification 2 Passport size photographs Declaration: I have carefully read the rules and regulations as given in this Application and agree to abide by the same. I understand these rules are only indicative and may be modified/changed/revised and the complete list of rules and regulations as updated from time to time will be given to me on my enrollment in the form of Student Hand Book. I agree not to countermand and to honor all the post dated cheques enclosed by me towards the Installment Facility. I understand that in case I withdraw from the program I will not be entitled to claim any refund of amount paid. I agree that I will settle the amount with ADTU whether or not I continue in the program, I understand the Jurisdiction for all disputes (if any) relating to the University is only/exclusively Guwahati, Assam. I hereby declare that the information provided by me in the Application is true and correct to the best of my knowledge. My signature below certifies that I have read understood and agree to the rules and regulations, including Legal Aspects, and my financial responsibilities.

Signature of the Applicant

For Office Use Approved Signature : Date : Processed Invoiced