04/09/2018 Print

REGISTRATION FORM

Amity Global Business School Hyderabad

Programme PGPM
Academic Session 2018-2019
Admission Category NS
Full Name of the Student HYDERABAD PRIYANKA REDDY
Father's Name HYDERABAD SANGAREDDY
Father's Occupation Private Sector Employee
Mother's Name HYDERABAD MANJULA
Mother's Occupation Not Working
Nationality Indian
Date of Birth THURSDAY, DECEMBER 18, 1997
Sex FEMALE
Category Gen
Emergency Contact No 8978411090
Aadhaar No 615604120365

Correspondence Address
Address H NO:1-6-106/1 SAI RAM NAGAR COLONY SANGA REDDY
City ZAHEERABAD
State Telangana
Country India
Pin 502220
Tel 04027202998
Fax 0
Mobile 7673925364
Email hyderabadpriyanka18@gmail.com

Permanent Address [Address of Parents]

Address H NO:1-6-106/1 SAI RAM NAGAR COLONY SANGA REDDY
City ZAHEERABAD
State Telangana
Country India
Pin 502220
Tel. 04027202998
Fax 0

Local Guardian(s) to be contacted in emergency

Full LG Name Enugu Vani reddy
[ Relative : Grand mother ]
Address malakpet
City hyderabad
State TS
Pin 500036
Tel.
Mobile No 9849810911
Fax
Email

Place of stay during this Semester

With Hostel
Address NA
City NA
State NA
Pin NA
Tel. NA
Mobile No NA
Email NA
Details of educational Qualification(from high School onwards)
Name of Year of Class/
Qualifying Passing School/College Board/University Subjects / Stream Percentage Divison/
Exam Grade
Xth 2013 Snghamitra high school State Board General 88.00 A

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XIIth 2015 CMS junior college State board MEC 95.90 A
Graduation 2018 Avinash degree college Osmania university BBA 86.00 A

Any type of sickness that you are prone to and the line of treatment
Any particular Doctor to be contacted in case of your sickness
Full Dr Name NA
Address NA
City NA
State NA
Pin NA
Tel. NA
Mobile No NA
Fax NA
Email NA

Your Blood Group O+VE

UNDERTAKING

I solemnly affirm that the above information made and furnished by me is true and correct. Further, I am being admitted to the
above stated Programme entirely on my request and I agree to abide by all the rules and regulations of the Institution/University
which I have read and understood. I was given opportunity to clarify any doubts I had and I shall not hold the
Institution/University responsible for not understanding the same. In the event of suppression or distortion of any fact like
educational qualification, nationality, etc. made in the Registration-cum-Enrolment Form, I understand that my admission is
liable for cancellation.

I have full knowledge of the fact that in case my attendance in any subject falls below 75%, I shall not be allowed to appear in
the end term Examinations

Date ______________________

Place ______________________

(Signature of Student)
Office Seal

(Name & Signature of the Verifying Faculty)

Date ______________________

For official use

Enrolment no. allotted

Date ______________________

Place ______________________
(Signature of Authorised Officer)

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