Jaipuria Institute of Managment, All Campuses

Full Name *

Email *

Phone Number *

Select Gender *

Date of Birth *

Blood Group

Aadhar Card Number

Qualifying Entrance Name & Percentile (XAT/CAT/CMAT/MAT) *

10th School Name

10th Board

Year of Passing

10th Percentage

12th School Name

12th Board

12th Year of Passing

12th Percentage

Graduation Degree (BBA/BCOM/BE/OTHERS) *

Graduation College Name

Graduation Pass Out Year

Graduation Percentage

Father's Name

Mother's Name

Parent's Phone Number

Father's Occupation

Complete Postal Address (With Pin Code)

City

State

I'we Confirm that I have read and agree to the Terms of the IANA EDUCATION Act Disciosure above.