Application Form EMBA 2013-15

Form #
(For University Use Only)

Please affix attested photograph 1.5 1.5 inch only

All fields in the application form are mandatory. 1. Personal Information Full Name (as it appears on your ID)
This is the name to be used for further correspondence with you. University Roll Number & Registration No. (For University Use Only)

Title
Please add the title you normally use e.g. Mr,Ms. Etc.

Father s / Guardians / Sponsors Name

Date of Birth
Candidate s Date of Birth

Day

Month

Year

Sex

Male

Female

Candidate s NIC No. Proposed Residence Permanent Address

Your permanent home address. This address will also be used as the address for correspondence unless you have a different mailing address

University Hostel

Any other hostel

Own

Other

Telephone Email
Please ensure you provide functional email address here. We will send out initial acknowledgment email to this email address. Email:

Mobile

Alternate email:

We expect that you check your sms / email at least once every working day.

Mailing Address
(If different from permanent address)

Telephone 2. Previous Education Are you applying as a result awaiting candidate. Are you enrolled in any another Programme.

Mobile

Yes Yes

No No

If you are enrolled in any other programme please provide the following details: Name of Institution Degree Programme Title End Date

Qualification:
Please give details starting with the most recent of all educational institutions attended and degrees awarded.

Name of Institution & Location

Major Subjects

Degree Awarded

CGPA/Grade/ Percentage

Dates From To

References:

Admission to EMBA requires two references, preferably one academic and one professional, although both references from professionals would be acceptable.

Referee 1 (Academic) Name: Job Title: Address: Tel: Email: Name: Job Title: Address: Tel: Email:

Referee 2 (Professional)

Please outline your career objectives and how this degree will help you to achieve them. Note: This response is of significant importance in your application processing.

Provide details of an initiative taken by you that helped improve a situation.

Employment Record
Please list your employment history or other professional work including internship, starting with the most recent.

From

To

Organization

Details of your main responsibilities

Salary

How do you think you can bring diversity to the department?

Please state to which other Universities you are applying?

We require this information for our own records. It does not affect your application in any way..

Sources of information about GCUMSD

Please indicate using the numbers 1 and 2 the first and Second most important sources of information which influenced you to apply for admission to GCUMSD Newspaper Advertisement Recommendation from students Postgraduate prospectus Recommendation from tutor Other (Please Specify) Website Open House Employer Information from MSD

Please give details of any special need, disability or illness that you would like us to be aware of.

Who will finance your education? Name: NIC No: Relationship (if any):
C I - h. 1. ~~

Declaration by the Applicant:

1. I pledge to fully abide by the Rules and Regulations of the G.C. University. 2 . I affirm that I have not taken admission in any other institution; I also affirm that I will not take admission in any institution during my stay in this University. If proved otherwise at any stage or time, my admission may be cancelled forthwith and all my dues paid to the University forfeited.. 3. I affirm that I was neither expelled/rusticated by any Institution at any time, nor was ever any disciplinary action taken against me, nor did I ever take part in any unlawful activity. 4. I affirm that if at any stage the documents submitted by me for admission are proved forged, fake or carry a mis-satatement or clerical error which may affect my merit, I shall be held responsible and that the University will be within its right to cancel my admission and to take the necessary action against me..

(of applicant) Good luck with your admission process.

Signature

Date

Declaration by the Father/Guardian/Sponsor:

I declare that in the event of admission of my son/daughter/ward to the G.C. University (I). I (father/guardian) will consider myself responsible for the payment of University fee and other dues, and that (2) I, will also be responsible for making up any loss/ damage caused by the applicant to the University property during the course of his/her stay in the University, (3) If, during the course of his/her studies, the applicant takes part in political activities or becomes a member of political or student s organization, I will be personally responsible for it and affirm that the Vice Chancellor will be within his rights to strike the applicant s name off the University Rolls; (4), I affirm that the Vice Cha ncellor can debar a student from appearing in the University Examination for lecture shortage, (5) that the Vice Chancellor is authorized to strike a student s name off the University Rolls as a punishment for the infringement of University Rules and Discipline (6) that if the documents submitted by my son/daughter/ward for admission are proved incorrect at any stage found to be fake or contain a mis-statement or error which may affect his/her merit, I will be held responsible and the University will have the authority to cancel his admission and to take disciplinary action against him/her. Signature of the individual who will pay for candidate, s education.

Payment Method:
Please enclose payment of Rs. 2000/- (Rs. 800/- to process your application and Rs. 1200/- for GCUMAT registration). Payment must be made through bank pay order/draft in favor of the Treasurer, G.C.University Lahore.

Application Checklist:
Have you attached the following documents with your application: 1. One photocopy of National Identity Card. 2. One attested photocopy of Matric/School Certificate Certificate. 3. One attested photocopy of Intermediate Certificate. 4. One attested photocopy of Bachelor s degree. 5. One attested photocopy of Master s degree (if applicable). 6. One photocopy of Father/Guardian/Sponsor s National I.D Card. 7. Three attested passport size photographs. 8. GMAT score (If available). 9 . Bank draft/Pay order of Rs. 2000/10. Reference letters 1 & 2. (Office Use Only)

Please bring the original certificates with you at the time of the interview. . NOTE: Please send the application forms via courier. Our staff is busy and cannot entertain walk-in-applicants. For further information on our Programmes visit the Management Studies Department website: www.gcumsd.edu.pk

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