Online Application Form


This page is an electronic version of the application form. Filling and submitting this form will navigate to an online payment process/page. If you don’t wish to do an online payment, you are requested to download the form, fill it and send it to your nearest GITM center.

Click here to download the Application Form

 


Name of the Course Applied for :  
Specialization (if any) :  
Full Name : Date of Birth (MM/DD/YY) :
Father's / Husbands Name : Address for Correspondence :
Mother's Name :
Mobile No. :    
E-mail ID : Permanent Address :
Gender :
Marital Status :
   
Education Qualification :-
Sr. No.DegreeName of InstitutionUniversity BoardYear of Passing% 
 
  Add
Note : Fill Value in these boxs and Click Add Button.

Experience Details :
Sr. No.Name of EmployerDate of JoiningDate of LeavingDesignationReason for change 
 
  Add
Note : Fill Value in these boxs and Click Add Button
Exam Option :
Fee Paid Amount :

 
GENIUS INSTITUTE OF TECHNOLOGY AND MANAGEMENT