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D u b a i C a m p u s
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| Email: admissions@manipaldubai.com | Website: apply.manipaldubai.com |
| Name of the program applied for {program} |
Application No. (For Official Use Only) {application} |
Date (For Official Use Only) {Date} |
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| 1. PERSONAL INFORMATION | SEX | {sex} | Blood Group | {bloodgroup} | ||
|---|---|---|---|---|---|---|
| Name of the candidate | {candidatename} | |||||
| Emirates Id | {emiratesid} | |||||
| Date of Birth | {dob} | Nationality | {nationality} | |||
| Place of Birth | {birthplace} | |||||
| Name, Relationship & Address of Parent/Local Guardian & Contact No. | ||||||
| Father's Name | {fathername} | Occupation | {occupation} | |||
| Name of the company | {companyname} | Designation | {designation} | |||
| Mother's Name | {mothername} | Emergency Contact No. | {emergencno} | |||
| Address for Correspondence | Permanent Address | |||||
| {corresondence} | {permanent} | |||||
| Mobile No. | {mobileno} | |||||
| E-Mail ID | {email} | |||||
| Parent's E-Mail ID | {pemail} | |||||
| Telephone No. | {telephone} | Fax No. | {fax} | |||
| Passport No | {passportno} | Passport Valid Until | {passportvalid} | |||
| Visa Required | {visarequired} | Visa Valid Until | {visavalid} | |||
| Current Visa Status | {visastatus} | Present Visa Number | {visanumber} | |||
| Sponsor & Other Details | |||||
|---|---|---|---|---|---|
| Name of Sponsor | {sponsor} | ||||
| Hostel Required | {hostelreq} | Transport Required | {transportreq} | ||
| Pick-up Point | {pickuppoint} | ||||
| School/College last studied | {laststudied} | ||||
| Name of the degree awarded | {degreeawarded} | ||||
| Name of the Board/University issuing certificate | {university} | ||||
| Month & Year of Passing | {yearofpassing} | Overall Aggregate | {aggregate} | ||
| Details of subject taken, and Grade/Marks scored in Examination | |||||
| Subjects | {sub1} | {sub2} | {sub3} | {sub4} | {sub5} |
| Marks | {marks1} | {marks2} | {marks3} | {marks4} | {marks5} |
| Maximum Marks | {max1} | {max2} | {max3} | {max4} | {max5} |
2. How do you know about us?
| Newspaper | Radio |
| Social Media | Manipal Dubai Website |
| Referred By | Others (Please specify): {others} |
3. Professional Information (For students of Master's Program Only)
| Position | Name & Address of the Organization | From | To |
|---|---|---|---|
| {position} | {organization} | {from} | {to} |
I hereby declare that all the information given, and statements made in this application and its accompanying attachments and enclosures are true to the best of my knowledge.
Once paid, Application Fee and Registration fee is non-refundable.
I, the candidate (or) parent/guardian of aforementioned (as applicable), have understood and agree to the refund policy available on www.manipaldubai.com.
| Date |
Signature of the Student I have read and accepted the refund policy |
Signature of Parent/Guardian I have read and accepted the refund policy |
Attested copy of the mark-sheet/grade sheet of standard 12 examination / equivalent (*original +one photocopy)
Standard 10 mark-sheet (*original +one photocopy)
Transfer certificate or school leaving certificate (originals will not be returned)
Conduct certificate issued by the school (originals will not be returned)
Passport copy
Four Passport-size photographs
Visa & Emirates Id
*Originals will be returned after verification
List of documents to be enclosed along with application for Masters Programs:
Certified copy of Bachelor's Degree and copy of mark-sheet (along with the original*)
Passport copy
Five passport-size photographs
Visa & Emirates Id
FOR OFFICIAL USE ONLY
Admitted to: ______________________________________________ Program: ______________________________________________
Registration Fee Paid: Yes ____________________ No__________________ Rt. No. _________________ Date ______________
Remark: __________________________________________________________ Signature (Accounts) ________________________________
Scholarship/Concession if given to Student _____________________________________________________________________________
| ADMISSION OFFICER | ACADEMIC DEAN |
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