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APPLICATION FOR STEP, TERM V 2017                                [pic 2]

Student Name:

Name*:  Ms./Mr.

………………………………………………………………………………………………….

(in BLOCK LETTERS)         (First Name)                   (Middle Name)                (Last Name)        Registration Number:

E-mail Address:

Date of birth:                

CGPA at the end of Term II:

(Your CGPA at the end of Term II should be at least 5.50)                                 

Passport Number:                                       Valid till:

If you do not have a passport, what steps you are taking to get one and when do you expect to get it?________________________________________________________________

______________________________________________________________________________

If you are doing your summer internship abroad, mention the firm and internship location: ______________________________________________________________________

Before coming to IIMC, if you have worked abroad, mention your employer, location of work abroad, and the duration of work: ________________________________________ ______________________________________________________________________________

Before coming to IIMC, if you have studied abroad, mention the institution, its location, and the duration of your study: _________________________________________