IASAM ACADEMY (Join Net Working For Dec./Reg. Education Without any Target & any Fees) DISTANCE ANDREGULAR EDUCATION (All University Approved& RecognizedByUGC/DEC/BCI/AICT/Govt.)10/12th/EnglishSpoken/Tally.Er/Diploma/Gradu./PG/LLB/LL M/BBA/MBA/BCA/MCA/B.Ed/M.Ed.&OthersIASAM ACADEMY-011-22043114. FRANCHISE BUSINESS MANAGER [FBM] 1. JODHPUR NATIONAL UNIVERSITY 2. JAIPUR NATIONAL UNIVERSITY 3. PACIFIC UNIVERSITY 4. NIMS UNIVERSITY 5. SWAMI VIVEKANAND UNIVERSITY 6. CMJ UNIVERSITY 7. NIILM UNIVERSITY 8. JHARKHAND ROY UNIVERSITY 9. SHOBHIT UNIVERSITY 10. KARPAGAM UNIVERSITY 11. ST.PETER UNIVERSITY 12. MSU TAMILNADU 13. KARNATAKA STATE OPEN UNIVERSITY 14. MANAV BHARTI UNIVERSITY 15. MAHATAMA GANDHI UNIVERSITY

1. I App lication No.
E DUCAT ION EM POWERS
Estabushed under section 3 of UGC Act, 1956
APPLICATION FORM FOR ADMISSION
Distance Education & Learning Programs
Enrollment No .
INSTRUCTIONS
• Form should be filled In Block Capital Letter In Eng lish Lang uage With Blue Ink Only.
• If yo u have any qu estions about your eligibility for a particular program, please
contact the Admission Cell before filling up the form .
• Filling up of Applicat ion form does not guarantee an admission .
(For Office UH' Only}
Regist ration No. _
Student File No . _
PROGRAM APPLYING FOR Ql
o
~ 1. _
Ql
Program name _ '§
0.. 2. _
.J::.
c:
£
(..)
3. _
-
Name of the applicant (exactly as it appears on academic High School transcript I certificate of qualifying examination)
P8Sle Recent
Passport size
Co loured
Photograph
(upload for onl ine
submission)
Mother's Name
LC---'-----'nFather's Name
Date of Birth
DO M M ~
ITJITJLIITJ
Gender
M ale D
Fem al e D
Category
General D ST D M inority D
SC 0 O B C (NOnCreamYLayerl D
If other, speci fy --=-c-=--- - ­
(tor aob reviatrons, rerer Part-B)
Physically
Handicapped
Yes D
No 0
Nationality
Indi an D Other D
If othe r, specify
Signature of the Applicant

2. CORRESPONDENCE ADDRESS (For all communication by the University)
Line 1 _
Line 2 City(Town _
Distt . State /Province Country _
Post Office Police Station Zip/Postal Code
QUALIFYING EXAM:
10+2 (12th) 0 3 yrs. Diploma after 10th 0 Graduation 0
DETAILS OF 10TH
Year of passing Board Stream Medium of Examination Total Marks
I 11----11--11_ _11__
DETAILS OF (10+2) 12TH
Year of passing Boar d Stream Medium of Examination Total Marks
I 11----11'------_11_ _11_ _
DETAILS OF DIPLOMA
Year of passing University ProgrammeName Medium of Examination Total Marks
I 11 ,11 II II__
DETAILS OF GRADUATION
Year of passing University ProgrammeName Medium of Examination Total Marks
[11 11 II IIL.....--_
DETAILS OF POST GRADUATION
Year of passing University Programme Name Medium of Examination Total Marks
I II 11_ _11 iI__
DETAILS OF OTHER BREAKING / LATERAL ENTRY
Year of passing University Programme Name Medium of Examination Total Marks
I II II II 11__
Post Graduati on 0
Marks Obtained %of Marks/CGPA
II II
Marks Obtained %ofMarks/CGPA
II II
Marks Obtained %01Marks/CGPA
II II
Marks Obtained %ofMarks/CGPA
II II
Marks Obtained %of Marks/CGPA
II II
Marks Obtained %01 Marks/CGPA
II II
DE.CLARATION BY THE APPLICANT
I, , S/D/o Shri .., ..
R/o .
seeking admission to programmeat Shobhit University, Meerut, hereby declare that allthe particulars givenabove
aretrue, complete and correct to the best of my knowledge and belief. I have never been convicted by any court of law or disqualified by any
Board/University. My candidature/admission may be cancelled and appropriate action be taken against me at any stage, if any information
furnished by me is found to be incorrect or misleading. I am aware of University approach toward agging and the punishment to which Iam
liable it found gUilty of ragging. Disputes, ifany,aresubject to Meerut jurisdiction only.
Sig ature of til e App icant