Application Form

Full Name (required):
Father/Husband Name(required):
Course Name:
Specialization in(1):
Specialization in(2):
Male/Female:
Date Of Birth
Nationality:
Your Email (required):
Phone(H):
Cell(M):
Address For Correspondence:
Permanent Address:
City :
Your Qualification :
Your Message

Acadmic Details
Degree	Name of School Collage	Month	Year	Subject Specialization	Result/Grade

Work Experience:
Exam Option:
Online/Study Center/From Home
Date:
Photo Upload:

Id Proof Upload:

10th Marksheet Upload:

12th Marksheet Upload:

Graduate:
Firat Year:

Second Year:

Third Year:

Any Degree:

Resume Upload:

Exeperiance letter:

Leaving Certificate:

WE DO ACCEPT FEES IN CASH

Declaration By The Candidate

I certify that all information provide on this appication proforma is complete and accurate

I agree to familiarize myself with all the rules and regulations of the program set forth by GIM and abide
By them.I would upload the standards and respect the principles of GIM organization of higher learning.

**Fees Once Paid will not be refunded or transferred to any name.

**In any case cheque bounce RS.500/- will be charged as a penalty.

**Cheque should be in favour of "Galaxy Institute of Management" GIM.

**Attested xerox copy of Marksheets and Certificates of all the Examination Cleared