Application Form
User Id: 6118564
CANDIDATES ARE REQUESTED TO RETAIN THE PRINTOUT OF ACKNOWLEDGEMENT PAGE FOR FUTURE REFERENCE.
Personal Details
Name of Candidate:
SHEENAM BHALLA
Father's/Husband's/Guardian's
Name :
mr shiv kumar bhalla
Mother's Name:
mrs neelima bhalla
Date of Birth:
19/Feb/1996
Candidate Gender:
Category:
General
State/Union Territory of
Caste/Tribe:
Serial Number of caste/Tribe:
Female
Caste/Tribe Name:
Country:
Indian
Person with Disability (PWD):
No
PWD Category:
Do you require wheelchair
support at the test centre?:
Disability Percentage:
Would you be using a scribe
for the Test?
Aadhar Card Number
Communication Address
b-1/78 ff paschim vihar new delhi
Address:
Country:
India
State/Union Territory:
DELHI
Other State/Union Territory:
District:
West Delhi
Other District:
Town/City:
delhi
Pin Code:
110063
Mobile Number:
9650022230
Email Address:
[email protected]
Email Address (Alternate) :
[email protected]
Mobile Number (Alternate) :
9650745229
Exam Centre City Preferences
Preferred City 1:
New Delhi
Preferred City 2:
Noida
Preferred City 3:
Greater Noida
Preferred City 4
Gurgaon
Academics Details
SSC/10th Std/Equivalent Details
Aggregate marks:
68.4
Month/Year of Completion:
March
Total Marks Obtained :
342
Maximum Marks :
500
SSC/10th Std/Equivalent Board
Name
Central Board of Secondary Education
2012
HSC/12th/Equivalent/Diploma Course Details
Course Type:
HSC
Aggregate Marks:
74.4
Total Marks Obtained:
372
Maximum Marks:
500
12th/Equivalent Board Name:
Central Board of Secondary Education
Duration of Diploma Course:
University/Board/Other Authority
Name:
Discipline:
Commerce
Month/Year of Course
Commencement:
Month/Year of Completion: March
First Bachelor Degree Details
Are you in the final year of Bachelor Degree?
Yes
I have more than one Bachelor's Degree?
Have you completed Bachelor
Degree?
Current Semester:
Semester-5
Type of University/Institution:
State University
State/Union Territory Where
University is Situated:
Delhi
University Name:
Guru Govind Singh Indraprastha
Name Of College:
vivekananda institute of professional studies
Degree Name:
BBA
Total Duration of Degree:
3 Year
Aggregate Marks:
80
2014
First Bachelor Degree Details
Discipline:
Management (Business Administration/Business Management/Business Studies/Management Studies)
Month/Year of Course
Commencement:
August
2014
June
Probable Month/Year OR
Month/Year of Completion:
Second Bachelor Degree Details
Are you in the final year of Bachelor Degree?
Have you completed Bachelor
Degree?
Total Duration of Degree:
Current Semester:
Aggregate Marks:
Type of University/Institution:
State/Union Territory Where
University is Situated:
University Name:
Name Of College:
Degree Name:
Discipline:
Probable Month/Year OR
Month/Year of Completion:
Month/Year of Course
Commencement:
Master Degree Details
Do you want to enter Master
Degree Details?
No
Master Degree Completion Status:
Duration:
Current Semester:
Aggregate Marks:
Type of University/Institution:
State/Union Territory of
University:
University Name:
Name of College/Institution:
Degree Name:
Discipline:
Month/Year of Course
Commencement:
Probable Month/Year OR
Month/Year of Completion:
2017
Other Professional Degree Details
Have you completed any professional degree such as CA/CS/ICWA? :
Professional Inter Marks:
No
Professional Final Marks:
Month/Year of Course
Commencement:
Month/Year of
Completion:
Work Experience Details
Automobiles/Auto-ancillaries
Banking/Financial Services
Durables
Engineering/Industrial
Fast Moving Consumer Goods
(FMCG)
Information Technology
Pharmaceuticals/Healthcare
Retail
Others
Telecommunications
Total Work Experience (In months
as on 31st July 2016)
Programme Details
Programme Names
Interview City
Selected / Not
IIM Ahmedabad PGP
(Interview City 1)
Not Selected
IIM Ahmedabad PGP
(Interview City 2)
Not Selected
IIM Ahmedabad PGP-FABM
Not Selected
IIM Ahmedabad FPM
Not Selected
IIM Amritsar PGP
Not Selected
IIM Bangalore PGP
Not Selected
IIM Bangalore PGPEM
Bangalore
Selected
IIM Bangalore PGPPM
Not Selected
IIM Bangalore FPM
Not Selected
IIM Bodh Gaya PGP
Not Selected
IIM Calcutta PGP PGDM
Not Selected
IIM Calcutta FPM
Not Selected
IIM Indore PGP
Not Selected
IIM Indore PGP Mumbai
Not Selected
IIM Indore EPGP
Not Selected
IIM Indore FPM
Not Selected
IIM Jammu PGP
Not Selected
IIM Kashipur PGP
Not Selected
IIM Kashipur EPGPM
Not Selected
IIM Kashipur EFPM
Not Selected
IIM Kashipur FPM
Not Selected
IIM Kozhikode PGP
Not Selected
IIM Kozhikode FPM
Not Selected
IIM Lucknow PGP
Not Selected
IIM Lucknow PGP ABM
Not Selected
IIM Lucknow PGPSM
Not Selected
IIM Lucknow FPM
Not Selected
IIM Nagpur PGP
Not Selected
IIM Raipur PGP
Not Selected
IIM Raipur PGPWE
Not Selected
IIM Raipur EFPM
Not Selected
IIM Raipur FPM
Not Selected
IIM Ranchi PGDM
Not Selected
IIM Ranchi PGDHRM
Not Selected
IIM Ranchi FPM
Not Selected
IIM Rohtak PGP
Not Selected
IIM Rohtak EPGP
Not Selected
IIM Rohtak FPM
Not Selected
IIM Sambalpur PGP
Not Selected
RGIIM Shillong PGP
Not Selected
RGIIM Shillong PGPEX
Not Selected
RGIIM Shillong FPM
Not Selected
IIM Sirmaur PGP
Not Selected
IIM Tiruchirappalli PGP
Not Selected
IIM Tiruchirappalli PGPBM
Not Selected
Not Selected
IIM Tiruchirappalli FPM
Delhi
IIM Udaipur PGP
Selected
IIM Udaipur FPM
Not Selected
IIM Visakhapatnam PGP
Not Selected
Payment Details
Payment Mode
Amount
Payment Status
Payment Transaction Number
Order ID
online
1700
GCIT4738557508
611856420160908204241521
DECLARATION
I have previewed the Application Form by clicking on the Preview Application Button and confirm that all the data reflecting in the Preview are correct.
I hereby certify that the information given by me in this Application Form is true to the best my knowledge. I certify that I fulfill the CAT 2016 eligibility
criteria and undertake to produce original documents whenever necessary and I will not demand any reschedule of exam. I agree to abide by the declaration
of the authorities regarding the eligibility of my application and understand that any misrepresentation or omission of facts in my application may justify
cancellation of my CAT 2016 application & scores. I understand that all disputes will be subject to the territorial jurisdiction of city of Bangalore only.
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Candidate Photograph
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