Application Form Step 1 of 5 20% Impact B School Note :Please read the instructions carefully before filling the form. Incomplete application will be rejectedCourse Opted(Required)BBABCAB.COMBACHELOR OF ENGINEERINGMBABSC INTERIOR DESIGNINGBACHELOR OD ARCHITECTURESpecialisation(Required)BBA Aviation ManagementBBA with Aviation & LogisticsBBA with LogisticsBBA with AviationSpecialisation(Required)BCA with Artificial IntelligenceBCA with Digital Forensic & Cyber SecurityBCA with Cloud Computing & Ethical HackingSpecialisation(Required)B.com with Stock Market TradingB.com with Logistics & Supply Chain ManagementB.com with Tourism & Hospitality ManagementB.com with ACCASpecialisation(Required)B.E in Electronics and CommunicationB.E in Electrical and ElectronicsCivil EngineeringMechanical EngineeringB.E in Computer ScienceB.E in Artificial IntelligenceSpecialisation(Required)MBA GlobalMBA CoreSpecialisation(Required)BSC Interior DesigningSpecialisation(Required)Bachelor Of ArchitectureMBA Global(Required)MBA with Aviation ManagementMBA with Logistics & Supply Chain ManagementMBA with MarketingMBA with FinanceMBA with HRMMBA Core(Required)MBA with MarketingMBA with FinanceMBA with HRMTitleMrMissApplicant Name (Block Letters)(Required) Applicant Email(Required) Applicant WhatsApp Number(Required) Date Of Birth(Required) MM slash DD slash YYYY Gender(Required)MaleFemaleTransgenderPlace Of Birth Aadhaar Number(Required)Nationality(Required) Religion(Required) Caste / Sub Caste(Required) Father Name Occupation & Annual Income Contact NumberEmail Mother Name Occupation & Annual Income Contact NumberEmail Permanent Address(Required) Street Address Address Line 2 City State ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Current Address Is Same As Permanent Address(Required)YesNoCurrent Address(Required) Street Address Address Line 2 City State ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Impact B School Note :Please read the instructions carefully before filling the form. Incomplete application will be rejectedDetails Of S.S.L.CName Of Board(Required) Date MM slash DD slash YYYY Subjects Studied Marks / Awarded (MARKS/MAX) Percentage Details Of 2nd PUC / EquivalentName Of Board Date MM slash DD slash YYYY Subjects Studied Marks Awarded (Marks/MAX) Percentage Details Of Degree / Diploma (If Any)Name Of Board Date MM slash DD slash YYYY Subjects Studied Marks Awarded (Marks/MAX) Percentage Proficiency & Co Curricular Activities (If Any)List All Co Curricular Activities Impact B School Note :Please read the instructions carefully before filling the form. Incomplete application will be rejectedApplicant Photo(Required)Max. file size: 3 MB.Applicant SignatureMax. file size: 2 MB.Parent SignatureMax. file size: 2 MB.Aadhaar CardAccepted file types: jpg, png, pdf, Max. file size: 5 MB.Transfer Certificate (TC)Max. file size: 5 MB.Study / Conduct CertificateMax. file size: 5 MB.Migration CertificateMax. file size: 5 MB. Impact B School Note :Please read the instructions carefully before filling the form. Incomplete application will be rejected• I hereby declare that the information provided in this application is true and complete to the best of my knowledge and belief, without evasion or misrepresentation. In case any information given in this application proves to be false or incorrect, I shall be responsible for the consequences. • I agree to abide by all the Rules and Regulations of the Institute in force and those which may be framed from time to time by the management. • I undertake that I will do nothing unworthy of a student of the Institute either inside or outside the campus or anything that may interfere with its orderly working and discipline. I am aware that the management has the full authority to expel me for disinterest in studies, misbehavior and repeated failures in tests/exams or absenteeism. • I agree that I will not indulge in Ragging and am aware that Ragging is banned in this Institute. If at any point of time, any incident of ragging comes to the notice of the authority, and if I cannot give satisfactory explanation, the authority may expel me from the Institute.(Required) I Agree To The Consent Impact B School Note :Please read the instructions carefully before filling the form. Incomplete application will be rejectedI hereby declare that I am aware of the financial obligations of admitting my son/daughter/ward to Impact Group Of Institutions. I agree to pay the tuition and other fees payable to the Institute, as prescribed from time to time. I also affirm and endorse the declaration made by my son/daughter/ward. (Required) I Agree To The Consent How did you hear about us ? 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