Mat Reg

Topics: Signature, Digital signature, Degree Pages: 3 (490 words) Published: January 18, 2013
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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|

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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. Endorse your...
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