D u b a i   C a m p u s
G-04 Dubai International Academic City
P.O. Box : 345050 - Dubai - UAE
Contact Details: +971 - 44290777

Email: admissions@manipaldubai.com Website: apply.manipaldubai.com

APPLICATION FORM FOR ADMISSION

Name of the program applied for

B.ARCH

 Application No. (For Official Use Only)

APP202100443

 Date

(For Official Use Only)

08-06-2020
1. PERSONAL INFORMATION SEX Female Blood Group
Name of the candidate ANANYA SHARMA
Emirates Id
Date of Birth 10/1/2001 12:00:00 AM Nationality IN
Place of Birth
Name, Relationship & Address of Parent/Local Guardian & Contact No.
Father's Name Occupation
Name of the company Designation
Mother's Name Emergency Contact No.
Address for Correspondence Permanent Address
,,,,- ,,,,-
Mobile No. 91-6239902451
E-Mail ID as745415@gmail.com
Parent's E-Mail ID
Telephone No. Fax No.
Passport No Passport Valid Until
Visa Required No Visa Valid Until
Current Visa Status Present Visa Number

Sponsor & Other Details
Name of Sponsor
Hostel Required No Transport Required No
Pick-up Point
School/College last studied
Name of the degree awarded 11th passed
Name of the Board/University issuing certificate {university}
Month & Year of Passing January-0001 Overall Aggregate
Details of subject taken, and Grade/Marks scored in Examination
Subjects
Marks
Maximum Marks

2. How do you know about us?

Newspaper Radio
Social Media Manipal Dubai Website
Referred By Others (Please specify):

3. Professional Information (For students of Master's Program Only)

Position Name & Address of the 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

List of documents to be enclosed along with application for Bachelor's Programs:

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