M

anipal

D
niversity

u b a i

a m p u s

G-04 Dubai International Academic City P.O. Box: 345050 Dubai UA.E
Tel. 00971 4 429 0777 / Toll free: 800 (MUDC) 6832

E-Mail: admissions@manipaldubai.com

Website: www.manipaldubai.com

APPLICATION FORM FOR ADMISSION Name Of The Program Applied For SIS # & DATE
(OFFICIAL USE ONLY)

PERSONAL INFORMATION Name of the candidate Date of birth Fathers name Mothers name Address for Correspondence

Sex

Blood Group

Nationality Occupation (parents)

Emergency Contact No.

Permanent Address

Students Mobile No. Telephone no. Fax No. E-Mail ID Passport No: Visa Required Current Visa status Name of Sponsor Hostel Required Yes No Transportation Required Yes No Yes No Visit Transit

Name, Relationship & Mobile No. of Parent / Local Guardian

Parent E-Mail ID Passport Valid until Visa Valid until Present Visa Number

Residence

Pickup Point

School / College last studied: Name of the degree awarded: Name of the Board / university issuing the certificate: Month and year of passing Details of subject taken and Grade / Marks scored in Examination: Subject Marks / Grade Maximum Marks How did you Know about us? Overall Aggregate %

3. PROFESSIONAL INFORMATION (For Students of Masters Program only) Position Name & Address of the organization From To

I hereby declare that all the information given and statements made in this application and its accompanying attachments and enclosures are true to the best of my knowledge. I agree to the condition that if any information or statement is found to be incorrect, my admission will automatically be cancelled. I, the Parent / Guardian of the aforementioned candidate am convinced and agree to the refund policy (mentioned below).

Date

Signature of the student

I have read and accepted the refund policy

Signature of Parent / Guardian

I have read and accepted the refund policy

List of documents to be enclosed along with application for Bachelors Programs: Attested copy of the mark-sheet /grade-sheet of 12th STD examination/equivalent. (*original + one photocopy). 10th STD mark-sheet. (*original + one photocopy). Scholarship (Graduate programs only) Transfer certificate or school leaving certificate. (originals will not be returned) Students scoring 70% and above in 12th grade or equivalent exam Conduct certificate issued by the school. (originals will not be returned) are eligible for 15% scholarship on the 1st semester fee. Passport copy. Students scoring 80% and above in 12th grade or equivalent exam 4 passport-size photographs. are eligible for 20% scholarship on the 1st semester fee. * Originals will be returned after verification Students scoring 90% and above in 12th grade or equivalent exam are eligible for 25% scholarship on the 1st semester fee. List of documents to be enclosed along with application for Masters Programs: Certified copy of Bachelors Degree and copy of mark sheet (along with the *original). One passport copy 5 Passport size photographs REFUND POLICY:
Students scoring 95% and above in 12th grade or equivalent exam are eligible for 30% scholarship on the 1st semester fee. To continue scholarship in subsequent semesters, student needs to maintain a GPA of 3.6 on a 4 point scale or 9 on a 10 point scale.

If the student withdraws from the Program, within two weeks from the commencement of the same, 50% amount of the 1st semester fee will be refunded. 15 days and above will entitle the student to lose the whole semester fee, the same refund policy applies to the 2nd semester. Note: Whole year Hostel & Transport fee is non refundable if the facility is withdrawn under any circumstance. Once paid, Application and Registration (Dhs.100/- & Dhs. 1500/- or Dhs.1000/-) is non-refundable under any circumstance.

FOR OFFICIAL USE ONLY

Admitted to: Registration Fee paid: Remarks: Scholarship / concession if given to Student Yes No

Program: Rt. No. Signature (Accounts) Date

ADMISSION OFFICER

ACADEMIC DEAN