-------------------------------------------------
Top of Form
Bottom of Form MAT REGISTRATION FORM (Feb-2013) |
* | Registration/Form No. |
*614517* | | * | Choice of Test Taking Option | Online (Computer Based Test) | | * | Test Centre City | Choice I. 503-KARNATAKA: BANGALORE | | | | Choice II. 606-TAMIL NADU: CHENNAI | | Personal Particulars | * | Name of Candidate | Mr. MOHAMMED QAMARUDDIN AMIR | | | | * | Date of Birth | 29-Aug-1990 | * | Gender | Male | * | Nationality | Indian | * | Category | GEN | * | Address for Communication | 26/2, ANJANEYA STREET, | | | | | | 6TH CROSS, XAVIER LAYOUT. | | | | | | BANGALORE-560047 | | | | * | City | BANGALORE | * | Pin Code | 560047 | | Email-ID | QAMARUDDIN_AMIR@YAHOO.COM | | Contact No. | 08025300949 | | Mobile No. | 9739090473 | Qualifications & Experience Details | * | Status of Degree | PASSED | | | | * | Percentage at 10+2 | 85 | * | Percentage at Degree | 69 | * | Stream/Discipline in Degree | COMMERCE | | Experience in Months | | | Have you earlier appeared in | GMAT : No | | CAT : Yes | XAT : No | Mode of Payment --> Credit/Debit Card | * | Transaction No./Receipt No. | 2000100402
300817413942 | * | Payment Date | 8-1-2013Declaration | | I hereby affirm that the particulars filled by me in this form are true and correct. I have read and understood the terms and conditions of the test and agree to abide by those. | | Registration/Form No. 614517 | | | Place | | Date | Signature of Applicant | | (To be signed prior to despatch) | Kindly save this page by using 'SAVE AS' function given in the 'FILE' menu of this window before taking the print out. | | | | (Please Print the form for Further Reference) | Important Instruction for Candidates: 1. Affix your passport size photograph (without attestation) in the space provided below. 2.