NO.
2011/
1.
APPLICATION FORM
Programme Applied For:
(Please tick in the relevant box. or in case you have applied for more than one programme, give relevant preference of ranking)
(Please me ntion the preference)
[1]
Under Graduate Programmes
[2]
BA (Hons) in Retail Management with Marketing*** (3 years)
Please affix
Graduate Programme in Retail Business Studies* + BBA** (3 years)
passport size
[1]
Post Graduate Programmes
[2]
[3]
PG Diploma in Retail Management* ( 1 year)
photograph in
the box
PG Diploma in Visual Merchandising and Store Design* (1 year)
PG Programme in Retail and Marketing* + MBA** (2 years)
2. Category (Kindly tick in the relevant box) : General
Company Sponsored
3. Name: ............................................................................................................................................................................................
4. Date of Birth : ...............................................................................................................................................................................
5. a. Father's Name : ..........................................................................................................................................................................
b. Father's Occupation : .....................................................................................................................................................................
c. Fathers Mobile No. ......................................................................................................................................................................
6.a. Mother's Name : .........................................................................................................................................................................
b. Mother's Occupation : ...................................................................................................................................................................
c. Mothers Mobile No. : ...................................................................................................................................................................
7. Family's Annual Income: Rs. 2-5 Lakhs
Rs 6-10 Lakhs
Rs. 10-15 Lakhs
Rs.15 Lakhs & above
8. a. Present Address : .......................................................................................................................................................................
........................................................................................................................................................................................................
b. Telephone No. (with STD code, if applicable) .........................................................................................................................
c. E-mail ID (Applicant's) : ...........................................................................................................................................................
d. Mobile No. (Applicant's) : .........................................................................................................................................................
9. Permanent Address : ......................................................................................................................................................................
........................................................................................................................................................................................................
........................................................................................................................................................................................................
* Autonomous Full Time Programme of IRS ** Degree through Distance Learning from a UGC recognized university *** Degree from University of Central Lancashire
10 a. Local Guardian's Name and Address (in case of out station candidate) : --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------b. Telephone No. (s):-------------------------------------------- Mobile: -------------------------------------------------------------------11. Educational Qualification:
a. Senior Secondary Board Examination
Discipline
Year
Institution
Board
%age
Main Subjects
b. Graduation / Professional
Course
Year
Board/University
Institution
%age
Main Subjects
12. Work Experience (if any)
Organization
Designation
Period
13. Extra Curricular Activities:
14. Special Awards / Merits / Scholarships:
Signature of the Applicant
Signature of Parent / Guardian
Date:.....................................
Date:.........................................
FOR OFFICE USE ONLY
Marks obtained in the Entrance Test ------------------------------------------------------------------------------------------------------Interview Panel Comments -------------------------------------------------------------------------- -------------------------------------------------------------------------------------------------------------------------------------------------------- --------------------------------
Interviewers Signature
N O . P G / 2 0 11 /
DECLARATION FORM
D E C L A R AT I O N B Y A P P L I C A N T W I T H C O M P O S I T E S C O R E
I N A N Y A I M A - M AT / C AT / X AT H E L D D U R I N G S e p 1 0 - M a y 11
(PLEASE READ NOTES BELOW CAREFULLY)
1. I had appeared in AIMA - MAT / CAT / XAT held in: (tick one) {IRS uses AIMA-MAT/CAT/XAT scores only for screening applicants for admissions}
September 2010
December 2010
February 2011
May 2011
Other
2
My composite score is:
(Attach copy of score card)
3. As per admission rules in the Prospectus 2011-12, I request to be waived the Written Admission Test:
Signature
Name
Yes
No
Date
Notes :
I. Applicants for PGDRM/PGPRM+MBA Programmes are entitled for waiver of Written Admission Test only if they are
eligible in the merit list prepared by IRS for any AIMA- MAT /CAT /XAT held during 2011-12. Such applicants will be called
for group discussions & personal interview directly.
II. It is open to an applicant of any of PG Programmes, with AIMA-MAT/CAT/XAT score, to not want waiver of Test, in such
case, applicant must clearly indicate.No in Serial No. 3 above.
III. Submission of this Declaration Form is compulsory for eligible applicants to obtain waiver of Test. In the absence of a
declaration or of copy of score card (serial no. 2 above) or of clear indication in Serial No. 3 above, applicant will have to
appear in Test.
IV. Decision to grant waiver of Test at Indian Retail School is not automatic.
V.
Applicants eligible for waiver of Test shall also fill in and submit ADMIT CARD along with APPLICATION FORM and
DECLARATION.
Admit Card
Post Graduate (Please tick in the relevant box )
[ ] Post Graduate Diploma in Retail Management* (1 year)
[ ] Post Graduate Programme in Retail & Marketing* + MBA** (2 years)
[ ] Post Graduate Diploma in Visual Merchandising and Store Design* (1 year)
Please affix
Under Graduate
passport size
[ ] Graduate Programme in Retail Business Studies* + BBA** (3 years)
photograph in
the box
Date of Examination
Time
: 10.00 am (be at the venue 15 minutes before this time)
Name
Phone No.
(to be filled by office)
Roll No.
Venue
: Indian Retail School
A-21/12, Naraina Industrial Area,
Phase-ll, New Delhi 110028
Signature of Examination Controller
* Autonomous Full Time Programme of IRS ** De gree through Distance Learning from a UGC recognized university *** Degree from University of Central Lancashire
