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Application No.

CET - 2007

ORISSA MANAGEMENT COLLEGES ASSOCIATION (OMCA)

APPLICATION FORM

(Fill all the information in Block Letters)

Affix recent
Passport Size
Photograph

1. Name of candidate:

2. Father’s Name:

3. Mother’s Name:

4. Date of Birth:

5. Complete Mailing Address:

6. Gender:

7. Nationlity:

8. Reservation Category:

Yes / No

9. Mother Tounge:

10. Year of Last Qualifying Examination:

11. Percentage of Marks in qualifying exam:

12. Form deposited at:

13.Choice of Centre
     (Centres will be allotted
     either by choice or by
     availability of seat).

(Candidates are requested to give their Mobile no. as exam venue will be intimated through SMS. In case of no mobile they have to give land number.)

Male Female

G.reen Card

Women

DECLARATION

I hereby declare that all the particulars stated above are true to the best of my knowledge and belief. I have read the information brochure carefully, and agree to abide by the terms and conditions therein. In the event of supression or distortion of any fact like category or educational qualifications or nationality, etc. I understand that I will be denied the opportunity to appear in the OMCA CET 2007 and if already admitted, my admission/ degree acquired is liable for cancellation. I understand that the decision of the participating institute/ college regarding my admission to MBA course is final and I shall abide by the decision. Further, if admitted, I promise to abide by the rules and norms of discipline of the institute/ college I join.


Place:


Date:



Signature of Parent/ Guardian.	Signature of the Applicant.