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cellpadding="0"> <tr> <td height="50" valign="top"><table width="100%" border="0" cellspacing="0" cellpadding="0"> <tr> <td height="19">&nbsp;</td> </tr> <tr bgcolor="#E7E3E3"> <td><img src="images/apply_online.jpg" /></td> </tr> </table></td> </tr> <tr> <td valign="top"><script language="JavaScript1.2" type="text/javascript">mmLoadMenus();</script> <table width="100%" border="0" cellspacing="0" cellpadding="0"> <tr> <td><table width="100%" border="0" cellspacing="0" cellpadding="0"> <tr> <td><form action="onlinemail.asp" method="post" name="frm" onsubmit="MM_validateForm('Family_Name','','R','First_Name','','R','Mailing_address','','R','Country','','R','Month','','R','Day','','R','Year','','R');return document.MM_returnValue" > <table width="100%" border="0" cellspacing="10" cellpadding="0"> <tr> <td colspan="2" class="bodyred" >Personal Profile </td> </tr> <tr> <td colspan="2" class="body"><table width="100%" border="0" cellspacing="0" cellpadding="0"> <tr> <td width="14%" style="font-family: Verdana, Helvetica, sans-serif;font-size: 11px;font-weight: normal;color: #000000;text-decoration: none;">Name of applicant </td> <td width="21%" align="left" class="bottomborder" style="padding-left:4px"> <input size="22" name="Family_Name" id="Family_Name" type="text" class="noborderfield" /> </td> <td width="21%" align="center" class="bottomborder"> <input size="22" name="First_Name" id="First_Name" type="text" class="noborderfield" /> </td> <td width="21%" align="center" class="bottomborder"> <input size="22" name="Middle_Name" id="Middle_Name" type="text" class="noborderfield" /> </td> <td width="9%" align="center"> <input name="Sex" type="radio" value="Male" /> <label>Male</label> </td> <td width="14%"><input name="Sex" type="radio" value="Female" /> Female</td> </tr> <tr> <td>&nbsp;</td> <td align="center">Family Name </td> <td align="center">First name </td> <td align="center">Middle Name </td> <td align="center">&nbsp;</td> <td>&nbsp;</td> </tr> </table></td> </tr> <tr> <td colspan="2" class="body"><table width="100%" border="0" cellspacing="0" cellpadding="0"> <tr> <td width="12%">Mailing Address </td> <td width="88%" align="left" class="bottomborder" style="padding-left:5px"><input size="120" name="Mailing_address" id="Mailing_address" type="text" class="noborderfield" /></td> </tr> </table></td> </tr> <tr> <td colspan="2" class="body"><table width="100%" border="0" cellspacing="0" cellpadding="0"> <tr> <td width="40%" class="bottomborder"><input size="60" name="City" id="City" type="text" class="noborderfield" /> </td> <td width="36%" align="center" class="bottomborder"><input size="30" name="Pin_Code" id="Pin_Code" type="text" class="noborderfield" /> </td> <td width="24%" align="center" class="bottomborder"><input size="40" name="Country" id="Country" type="text" class="noborderfield" /> </td> </tr> <tr> <td align="center">City</td> <td align="center">Pin Code </td> <td align="center">Country</td> </tr> </table></td> </tr> <tr> <td colspan="2" class="body"><table width="100%" border="0" cellspacing="0" cellpadding="0"> <tr> <td width="8%">Telephone</td> <td width="25%" align="left" class="bottomborder" style="padding-left:5px"><input size="28" name="Phone_office" id="Phone_office" type="text" class="noborderfield" /> </td> <td width="20%" align="center" class="bottomborder"><input size="22" name="Phone_residence" id="Phone_residence" type="text" class="noborderfield" /> </td> <td width="9%" align="right" style="padding-right:2px">Mobile</td> <td width="15%" align="center" class="bottomborder"><input size="22" name="Mobile" id="Mobile" type="text" class="noborderfield" /></td> <td width="8%" align="right" style="padding-right:2px">E- Mail </td> <td width="15%" class="bottomborder"><input size="22" name="Email2" id="Email2" type="text" class="noborderfield" /></td> </tr> <tr> <td>&nbsp;</td> <td align="center">Office </td> <td align="center">Residence</td> <td colspan="2" align="center">&nbsp;</td> <td align="center">&nbsp;</td> <td>&nbsp;</td> </tr> </table></td> </tr> <tr> <td colspan="2" class="body"><table width="100%" border="0" cellspacing="0" cellpadding="0"> <tr> <td width="13%">Date Of Birth </td> <td width="6%" align="center" class="bottomborder" style="padding-left:3px"><input size="8" name="Month" id="Month" type="text" class="noborderfield" /> </td> <td width="1%" align="left" valign="bottom" style="padding-right:2px" class="body">/</td> <td width="7%" align="center" class="bottomborder"><input size="10" name="Day" id="Day" type="text" class="noborderfield" /></td> <td width="1%" align="left" valign="bottom" style="padding-right:2px" class="body">/</td> <td width="7%" align="center" class="bottomborder"><input size="10" name="Year" id="Year" type="text" class="noborderfield" /></td> <td width="23%" align="right" style="padding-right:4px">City &amp; Country of Birth </td> <td width="42%" align="left" class="bottomborder"><input size="50" name="Country_of_Birth" id="Country_of_Birth" type="text" class="noborderfield" /></td> </tr> <tr> <td>&nbsp;</td> <td align="center">Month </td> <td align="center">&nbsp;</td> <td align="center">Day</td> <td align="center">&nbsp;</td> <td align="center">Year</td> <td colspan="2" align="center">&nbsp;</td> </tr> </table></td> </tr> <tr> <td colspan="2" class="body"><table width="100%" border="0" cellspacing="0" cellpadding="0"> <tr> <td width="9%" style="padding-right:2px">Citizen of </td> <td width="28%" class="bottomborder"><input size="40" name="Citizen" id="Citizen" type="text" class="noborderfield" /></td> <td width="12%" align="right" style="padding-right:2px">Passport No </td> <td width="20%" align="center" class="bottomborder"><input size="25" name="Passport_no" id="Passport_no" type="text" class="noborderfield" /></td> <td width="14%" align="right" style="padding-right:2px">Place of Issue </td> <td width="17%" align="center" class="bottomborder"><input size="25" name="Place_of_Issue" id="Place_of_Issue" type="text" class="noborderfield" /></td> </tr> </table></td> </tr> <tr> <td colspan="2" class="body"><table width="100%" border="0" cellspacing="0" cellpadding="0"> <tr> <td width="19%" style="padding-right:2px">Education Obejective </td> <td width="13%"><label> <input name="Education_Obejective1" type="checkbox" id="Education_Obejective1" value="BBA" /> BBA / BS </label></td> <td width="14%">&nbsp;</td> <td width="26%" align="right" style="padding-right:2px"> <input name="Education_Obejective2" type="checkbox" id="Education_Obejective2" value="MBA" />MBA </td> <td width="8%" align="center"><input name="Education_Obejective3" type="checkbox" id="Education_Obejective3" value="MS" /> MS </td> <td width="6%" align="right" style="padding-right:2px"> <input name="Education_Obejective4" type="checkbox" id="Education_Obejective4" value="MA" /> MA </td> <td width="14%" align="center"><input name="Education_Obejective5" type="checkbox" id="Education_Obejective5" value="Other" /> Other </td> </tr> </table></td> </tr> <tr> <td colspan="2" class="body"><table width="100%" border="0" cellspacing="0" cellpadding="0"> <tr> <td width="12%">Intended Major </td> <td width="44%" align="center" class="bottomborder"><input size="60" name="First_Preference" id="First_Preference" type="text" class="noborderfield" /> </td> <td width="2%" align="left" valign="bottom" class="body">/</td> <td width="42%" align="center" class="bottomborder"><input size="60" name="Second_Preference" id="Second_Preference" type="text" class="noborderfield" /></td> </tr> <tr> <td>&nbsp;</td> <td align="center">First Preference </td> <td align="center">&nbsp;</td> <td align="center">Second Preference </td> </tr> </table></td> </tr> <tr> <td colspan="2" class="body"><table width="100%" border="0" cellspacing="0" cellpadding="0"> <tr> <td width="56%">Please indicate the semester you wish to begin your university studies </td> <td width="11%" align="center"><input name="Semester1" type="checkbox" id="Semester1" value="Transfer" /> Transfer </td> <td width="8%" align="center"><input name="Semester2" type="checkbox" id="Semester2" value="Fall" /> Fall </td> <td width="7%" align="right" class="body" style="padding-right:3px">Year</td> <td width="18%" align="center" class="bottomborder"><input size="25" name="Semester_Year" id="Semester_Year" type="text" class="noborderfield" /></td> </tr> </table></td> </tr> <tr> <td colspan="2" class="body"><table width="100%" border="0" cellspacing="0" cellpadding="0"> <tr> <td width="25%">States or Cities preffered, if any </td> <td width="75%" align="left" class="bottomborder"><input size="100" name="Status_of_cities" id="Status_of_cities" type="text" class="noborderfield" /> </td> </tr> </table></td> </tr> <tr> <td colspan="2" class="body"><table width="100%" border="0" cellspacing="0" cellpadding="0"> <tr> <td width="29%">Budget (in U.S. $ per academic year) </td> <td width="19%" align="left" class="bottomborder"><input size="25" name="Budget" id="Budget" type="text" class="noborderfield" /> </td> <td width="32%" align="right" class="body" style="padding-right:3px">Financial Support will be provided by : </td> <td width="20%" align="left" class="bottomborder"><input size="25" name="Financial_Support" id="Financial_Support" type="text" class="noborderfield" /></td> </tr> </table></td> </tr> <tr> <td colspan="2" class="body"><table width="100%" border="0" cellspacing="0" cellpadding="0"> <tr> <td width="34%">Special Awards / Achievement / Certificates </td> <td width="66%" align="left" class="bottomborder"><input size="90" name="Special_Awards" id="Special_Awards" type="text" class="noborderfield" /> </td> </tr> </table></td> </tr> <tr> <td colspan="2" class="bottomborder"> <input size="140" name="Special_Awards2" id="Special_Awards2" type="text" class="noborderfield" /> </td> </tr> <tr> <td colspan="2" class="body"><table width="100%" border="0" cellspacing="0" cellpadding="0"> <tr> <td width="13%">Computer Skills </td> <td width="87%" align="left" class="bottomborder"><input size="120" name="Computer_Skills" id="Computer_Skills" type="text" class="noborderfield"></td> </tr> </table></td> </tr> <tr> <td colspan="2" class="body"><table width="100%" border="0" cellspacing="0" cellpadding="0"> <tr> <td width="58%">Have you ever been outside India? If yes, mention the countries visited </td> <td width="42%" align="left" class="bottomborder"><input size="50" name="outside_India" id="outside_India" type="text" class="noborderfield" /> </td> </tr> </table></td> </tr> <tr> <td colspan="2" class="bottomborder"> <input name="outside_India1" id="outside_India1" type="text" class="noborderfield" size="140" /> </td> </tr> <tr> <td colspan="2" class="body"><table width="100%" border="0" cellspacing="0" cellpadding="0"> <tr> <td width="29%">Which foreign language do you know? </td> <td width="71%" align="left" class="bottomborder"><input size="95" name="foregn_language" id="foregn_language" type="text" class="noborderfield" /> </td> </tr> </table></td> </tr> <tr> <td colspan="2" class="bodyred">&nbsp;</td> </tr> <tr> <td colspan="2" class="bodyred">Family Background</td> </tr> <tr> <td width="50%" class="body"><table width="95%" border="0" cellspacing="0" cellpadding="0"> <tr> <td width="33%">Father's full Name : </td> <td width="67%" align="left" class="bottomborder"><input size="40" name="Father_name" id="Father_name" type="text" class="noborderfield" /> </td> </tr> </table></td> <td width="50%" align="right" class="body"><table width="95%" border="0" cellspacing="0" cellpadding="0"> <tr> <td width="36%" align="left">Mother's full Name : </td> <td width="64%" align="left" class="bottomborder"><input size="40" name="Mother_name" id="Mother_name" type="text" class="noborderfield" /> </td> </tr> </table></td> </tr> <tr> <td class="body"><table width="95%" border="0" cellspacing="0" cellpadding="0"> <tr> <td width="17%">Address : </td> <td width="83%" align="left" class="bottomborder"><input size="55" name="Father_Address" id="Father_Address" type="text" class="noborderfield" /></td> </tr> </table></td> <td align="right" class="body"><table width="95%" border="0" cellspacing="0" cellpadding="0"> <tr> <td width="17%" align="left">Address : </td> <td width="83%" align="left" class="bottomborder"><input size="55" name="Mother_Address" id="Mother_Address" type="text" class="noborderfield" /> </td> </tr> </table></td> </tr> <tr> <td class="body"><table width="95%" border="0" cellspacing="0" cellpadding="0"> <tr> <td width="15%">Phone : </td> <td width="85%" align="left" class="bottomborder"><input size="55" name="Father_Phone" id="Father_Phone" type="text" class="noborderfield" /> </td> </tr> </table></td> <td align="right" class="body"><table width="95%" border="0" cellspacing="0" cellpadding="0"> <tr> <td width="15%" align="left">Phone : </td> <td width="85%" align="left" class="bottomborder"><input size="55" name="Mother_Phone" id="Mother_Phone" type="text" class="noborderfield" /> </td> </tr> </table></td> </tr> <tr> <td class="body"><table width="95%" border="0" cellspacing="0" cellpadding="0"> <tr> <td width="15%">Email : </td> <td width="31%" align="left" class="bottomborder"><input size="20" name="Father_Email" id="Father_Email" type="text" class="noborderfield" /> </td> <td width="25%" align="right">Education : </td> <td width="29%" align="right" class="bottomborder"><input size="20" name="Father_education" id="Father_education" type="text" class="noborderfield" /></td> </tr> </table></td> <td align="right" class="body"><table width="95%" border="0" cellspacing="0" cellpadding="0"> <tr> <td width="15%">Email : </td> <td width="31%" align="left" class="bottomborder"><input size="20" name="Mother_Email" id="Mother_Email" type="text" class="noborderfield" /> </td> <td width="25%" align="right">Education : </td> <td width="29%" align="right" class="bottomborder"><input size="20" name="Mother_education" id="Mother_education" type="text" class="noborderfield" /></td> </tr> </table></td> </tr> <tr> <td class="body"><table width="95%" border="0" cellspacing="0" cellpadding="0"> <tr> <td width="32%" align="left">Name of College : </td> <td width="68%" align="left" class="bottomborder"><input size="40" name="Father_Collage" id="Father_Collage" type="text" class="noborderfield" /> </td> </tr> </table></td> <td align="right" class="body"><table width="95%" border="0" cellspacing="0" cellpadding="0"> <tr> <td width="32%" align="left">Name of College : </td> <td width="68%" align="left" class="bottomborder"><input size="40" name="Mother_Collage" id="Mother_Collage" type="text" class="noborderfield" /> </td> </tr> </table></td> </tr> <tr> <td class="body"><table width="95%" border="0" cellspacing="0" cellpadding="0"> <tr> <td width="17%">Degree : </td> <td width="38%" align="left" class="bottomborder"><input size="25" name="Father_Degree" id="Father_Degree" type="text" class="noborderfield" /> </td> <td width="16%" align="right">Year : </td> <td width="29%" align="right" class="bottomborder"><input size="20" name="Father_Year2" id="Father_Year2" type="text" class="noborderfield" /></td> </tr> </table></td> <td align="right" class="body"><table width="95%" border="0" cellspacing="0" cellpadding="0"> <tr> <td width="17%">Degree : </td> <td width="38%" align="left" class="bottomborder"><input size="25" name="Mother_Degree" id="Mother_Degree" type="text" class="noborderfield" /> </td> <td width="16%" align="right">Year : </td> <td width="29%" align="right" class="bottomborder"><input size="20" name="Mother_Year2" id="Mother_Year2" type="text" class="noborderfield" /></td> </tr> </table></td> </tr> <tr> <td><table width="95%" border="0" cellspacing="0" cellpadding="0"> <tr> <td width="53%" align="left" class="body">Name of Post Graduate School: </td> <td width="47%" align="left" class="bottomborder"><input size="30" name="Father_School" id="Father_School" type="text" class="noborderfield" /> </td> </tr> </table></td> <td align="right"><table width="95%" border="0" cellspacing="0" cellpadding="0"> <tr> <td width="53%" align="left" class="body">Name of Post Graduate School: </td> <td width="47%" align="left" class="bottomborder"><input size="30" name="Mother_School" id="Mother_School" type="text" class="noborderfield" /> </td> </tr> </table></td> </tr> <tr> <td class="body"><table width="95%" border="0" cellspacing="0" cellpadding="0"> <tr> <td width="17%">Degree : </td> <td width="38%" align="left" class="bottomborder"><input size="25" name="Father_Degree3" id="Father_Degree3" type="text" class="noborderfield" /> </td> <td width="16%" align="right">Year : </td> <td width="29%" align="right" class="bottomborder"><input size="20" name="Father_Year3" id="Father_Year3" type="text" class="noborderfield" /></td> </tr> </table></td> <td align="right" class="body"><table width="95%" border="0" cellspacing="0" cellpadding="0"> <tr> <td width="17%">Degree : </td> <td width="38%" align="left" class="bottomborder"><input size="25" name="Mother_Degree3" id="Mother_Degree3" type="text" class="noborderfield" /> </td> <td width="16%" align="right">Year : </td> <td width="29%" align="right" class="bottomborder"><input size="20" name="Mother_Year3" id="Mother_Year3" type="text" class="noborderfield" /></td> </tr> </table></td> </tr> <tr> <td colspan="2"><table width="100%" border="0" cellspacing="0" cellpadding="0"> <tr> <td width="16%" class="body">Student 's Siblings: </td> <td width="29%" align="center" class="bottomborder"><input size="40" name="Siblings_Family_Name" id="Siblings_Family_Name" type="text" class="noborderfield" /> </td> <td width="17%" align="center" class="bottomborder"><input size="22" name="Siblings_Age" id="Siblings_Age" type="text" class="noborderfield" /> </td> <td width="38%" align="center" class="bottomborder"><input size="50" name="Siblings_Qualification" id="Siblings_Qualification" type="text" class="noborderfield" /> </td> </tr> <tr> <td>&nbsp;</td> <td align="center" class="body">Family Name </td> <td align="center" class="body">Age </td> <td align="center" class="body">Qualification</td> </tr> <tr> <td width="16%" class="body"> </td> <td width="29%" align="center" class="bottomborder"><input size="40" name="Siblings_Family_Name2" id="Siblings_Family_Name2" type="text" class="noborderfield" /> </td> <td width="17%" align="center" class="bottomborder"><input size="22" name="Siblings_Age2" id="Siblings_Age2" type="text" class="noborderfield" /> </td> <td width="38%" align="center" class="bottomborder"><input size="50" name="Siblings_Qualification2" id="Siblings_Qualification2" type="text" class="noborderfield" /> </td> </tr> <tr> <td>&nbsp;</td> <td align="center" class="body">Family Name </td> <td align="center" class="body">Age </td> <td align="center" class="body">Qualification</td> </tr> </table></td> </tr> <tr> <td colspan="2"><span class="bodyred">Educational History </span></td> </tr> <tr> <td colspan="2" bgcolor="#DBDBDB"> <table width="100%" border="0" cellspacing="1" cellpadding="0"> <tr> <td width="26%" height="21" align="center" bgcolor="#FFFFFF" class="body">&nbsp;</td> <td width="19%" align="center" bgcolor="#FFFFFF" class="style2">Name &amp; laocation </td> <td width="11%" align="center" bgcolor="#FFFFFF" class="style2">From<br /> (mo./ yr.) </td> <td width="13%" align="center" bgcolor="#FFFFFF" class="style2">To <br /> (mo. / yr.) </td> <td width="22%" align="center" bgcolor="#FFFFFF" class="style2">Name of <br /> Degree / Diploma </td> <td width="9%" align="center" bgcolor="#FFFFFF" class="style2">% Marks </td> </tr> <tr> <td height="21" bgcolor="#FFFFFF" class="body" style="padding-left:3px">Primary School <span class="bodyblack">(<em>Nur. - IVth</em></span>) </td> <td align="center" bgcolor="#FFFFFF"><input size="22" name="Name_location" id="Name_location" type="text" class="noborderfield" /></td> <td align="center" bgcolor="#FFFFFF"><input size="12" name="from_month" id="from_month" type="text" class="noborderfield" /></td> <td align="center" bgcolor="#FFFFFF"><input size="15" name="to_month" id="to_month" type="text" class="noborderfield" /></td> <td align="center" bgcolor="#FFFFFF"><input size="25" name="degree_diploma" id="degree_diploma" type="text" class="noborderfield" /></td> <td align="center" bgcolor="#FFFFFF"><input size="8" name="marks" id="marks" type="text" class="noborderfield" /></td> </tr> <tr> <td height="21" bgcolor="#FFFFFF" class="body" style="padding-left:3px">Secondary School (<span class="bodyblack">Vth - Xth</span>) </td> <td align="center" bgcolor="#FFFFFF"><input size="22" name="Name_location2" id="Name_location2" type="text" class="noborderfield" /></td> <td align="center" bgcolor="#FFFFFF"><input size="12" name="from_month2" id="from_month2" type="text" class="noborderfield" /></td> <td align="center" bgcolor="#FFFFFF"><input size="15" name="to_month2" id="to_month2" type="text" class="noborderfield" /></td> <td align="center" bgcolor="#FFFFFF"><input size="25" name="degree_diploma2" id="degree_diploma2" type="text" class="noborderfield" /></td> <td align="center" bgcolor="#FFFFFF"><input size="8" name="marks2" id="marks2" type="text" class="noborderfield" /></td> </tr> <tr> <td height="21" bgcolor="#FFFFFF" class="body" style="padding-left:3px">High School (<span class="bodyblack">XIth - XIIth</span>) </td> <td align="center" bgcolor="#FFFFFF"><input size="22" name="Name_location3" id="Name_location3" type="text" class="noborderfield" /></td> <td align="center" bgcolor="#FFFFFF"><input size="12" name="from_month3" id="from_month3" type="text" class="noborderfield" /></td> <td align="center" bgcolor="#FFFFFF"><input size="15" name="to_month3" id="to_month3" type="text" class="noborderfield" /></td> <td align="center" bgcolor="#FFFFFF"><input size="25" name="degree_diploma3" id="degree_diploma3" type="text" class="noborderfield" /></td> <td align="center" bgcolor="#FFFFFF"><input size="8" name="marks3" id="marks3" type="text" class="noborderfield" /></td> </tr> <tr> <td height="21" bgcolor="#FFFFFF" class="body" style="padding-left:3px">College / University </td> <td align="center" bgcolor="#FFFFFF"><input size="22" name="Name_location4" id="Name_location4" type="text" class="noborderfield" /></td> <td align="center" bgcolor="#FFFFFF"><input size="12" name="from_month4" id="from_month4" type="text" class="noborderfield" /></td> <td align="center" bgcolor="#FFFFFF"><input size="15" name="to_month4" id="to_month4" type="text" class="noborderfield" /></td> <td align="center" bgcolor="#FFFFFF"><input size="25" name="degree_diploma4" id="degree_diploma4" type="text" class="noborderfield" /></td> <td align="center" bgcolor="#FFFFFF"><input size="8" name="marks4" id="marks4" type="text" class="noborderfield" /></td> </tr> <tr> <td height="21" bgcolor="#FFFFFF" class="body" style="padding-left:3px">Others</td> <td align="center" bgcolor="#FFFFFF"><input size="22" name="Name_location5" id="Name_location5" type="text" class="noborderfield" /></td> <td align="center" bgcolor="#FFFFFF"><input size="12" name="from_month5" id="from_month5" type="text" class="noborderfield" /></td> <td align="center" bgcolor="#FFFFFF"><input size="15" name="to_month5" id="to_month5" type="text" class="noborderfield" /></td> <td align="center" bgcolor="#FFFFFF"><input size="25" name="degree_diploma5" id="degree_diploma5" type="text" class="noborderfield" /></td> <td align="center" bgcolor="#FFFFFF"><input size="8" name="marks5" id="marks5" type="text" class="noborderfield" /></td> </tr> </table></td> </tr> <tr> <td colspan="2"><table width="100%" border="0" cellspacing="0" cellpadding="0"> <tr> <td width="30%" class="body">Subjects you are currently enrolled in </td> <td width="70%" align="left" class="bottomborder"><input size="100" name="Subject_enrolled" id="Subject_enrolled" type="text" class="noborderfield" /></td> </tr> </table></td> </tr> <tr> <td colspan="2"><span class="bodyred">Standardized Tests </span></td> </tr> <tr> <td colspan="2" bgcolor="#DBDBDB"><table width="100%" border="0" cellspacing="1" cellpadding="0"> <tr> <td width="19%" height="25" align="center" bgcolor="#FFFFFF" class="body">&nbsp;</td> <td width="59%" align="center" bgcolor="#FFFFFF" class="style2">Name &amp; location </td> <td width="22%" align="center" bgcolor="#FFFFFF" class="style2">Date taken /to be taken </td> </tr> <tr> <td align="left" bgcolor="#FFFFFF" class="body" style="padding-left:3px">TOEFLI iBT </td> <td align="left" bgcolor="#FFFFFF"><table width="100%" border="0" cellspacing="0" cellpadding="0"> <tr> <td align="left" class="body">Reading </td> <td align="left" class="body">Writing </td> <td align="left" class="body">Speaking</td> <td align="left" class="body">Listening</td> <td align="left" class="body"> TOTAL </td> </tr> <tr> <td align="left"><input size="15" name="toefl_reading" id="toefl_reading" type="text" class="noborderfield" /></td> <td align="left"><input size="15" name="toefl_writing" id="toefl_writing" type="text" class="noborderfield" /></td> <td align="left"><input size="15" name="toefl_Speaking" id="toefl_Speaking" type="text" class="noborderfield" /></td> <td align="left"><input size="15" name="toefl_listining" id="toefl_listining" type="text" class="noborderfield" /></td> <td align="left"><input size="15" name="toefl_Total" id="toefl_Total" type="text" class="noborderfield" /></td> </tr> </table></td> <td align="center" bgcolor="#FFFFFF"><input size="20" name="toefl_datetaken" id="toefl_datetaken" type="text" class="noborderfield" /></td> </tr> <tr> <td align="left" bgcolor="#FFFFFF" class="body" style="padding-left:3px">SAT - I </td> <td align="left" bgcolor="#FFFFFF"><table width="100%" border="0" cellspacing="0" cellpadding="0"> <tr> <td width="21%" align="left" class="body">Writing </td> <td width="21%" align="left" class="body">Maths</td> <td width="38%" align="left" class="body">Critical Reading </td> <td width="20%" align="left" class="body"> TOTAL </td> </tr> <tr> <td align="left"><input size="15" name="sat1_writing" id="sat1_writing" type="text" class="noborderfield" /></td> <td align="left"><input size="15" name="sat1_maths" id="sat1_maths" type="text" class="noborderfield" /></td> <td align="left"><input size="25" name="sat1_critical" id="sat1_critical" type="text" class="noborderfield" /></td> <td align="left"><input size="15" name="sat1_total" id="sat1_total" type="text" class="noborderfield" /></td> </tr> </table></td> <td align="center" bgcolor="#FFFFFF"><input size="20" name="sat1_datetaken" id="sat1_datetaken" type="text" class="noborderfield" /></td> </tr> <tr> <td align="left" bgcolor="#FFFFFF" class="body" style="padding-left:3px">GMAT</td> <td align="left" bgcolor="#FFFFFF"><table width="100%" border="0" cellspacing="0" cellpadding="0"> <tr> <td width="21%" align="left" class="body">verbal </td> <td width="21%" align="left" class="body">Quant.</td> <td width="38%" align="left" class="body">AWA </td> <td width="20%" align="left" class="body"> TOTAL </td> </tr> <tr> <td align="left"><input size="15" name="gmat_vearbal" id="gmat_vearbal" type="text" class="noborderfield" /></td> <td align="left"><input size="15" name="gmat_quant" id="gmat_quant" type="text" class="noborderfield" /></td> <td align="left"><input size="25" name="gmat_awa" id="gmat_awa" type="text" class="noborderfield" /></td> <td align="left"><input size="15" name="gmat_total" id="gmat_total" type="text" class="noborderfield" /></td> </tr> </table></td> <td align="center" bgcolor="#FFFFFF"><input size="20" name="gmat_datetaken" id="gmat_datetaken" type="text" class="noborderfield" /></td> </tr> <tr> <td align="left" bgcolor="#FFFFFF" class="body" style="padding-left:3px">GRE</td> <td align="left" bgcolor="#FFFFFF"><table width="100%" border="0" cellspacing="0" cellpadding="0"> <tr> <td width="21%" align="left" class="body">verbal </td> <td width="21%" align="left" class="body">Quant.</td> <td width="38%" align="left" class="body">AWA </td> <td width="20%" align="left" class="body"> TOTAL </td> </tr> <tr> <td align="left"><input size="15" name="Gre_vearbal2" id="Gre_vearbal2" type="text" class="noborderfield" /></td> <td align="left"><input size="15" name="Gre_quant" id="Gre_quant" type="text" class="noborderfield" /></td> <td align="left"><input size="25" name="Gre_awa" id="Gre_awa" type="text" class="noborderfield" /></td> <td align="left"><input size="15" name="Gre_awa1" id="Gre_awa1" type="text" class="noborderfield" /></td> </tr> </table></td> <td align="center" bgcolor="#FFFFFF"><input size="20" name="First_Name471168" id="First_Name471168" type="text" class="noborderfield" /></td> </tr> <tr> <td height="25" align="left" bgcolor="#FFFFFF" class="body" style="padding-left:3px">Others <span class="bodyblack">(SAT-II / AGRE) </span></td> <td align="left" bgcolor="#FFFFFF"><input size="60" name="Other_sat2" id="Other_sat2" type="text" class="noborderfield" /></td> <td align="center" bgcolor="#FFFFFF"><input size="20" name="Other_datetaken" id="Other_datetaken" type="text" class="noborderfield" /></td> </tr> </table></td> </tr> <tr> <td colspan="2" class="bodyred">Work Experience </td> </tr> <tr> <td colspan="2" bgcolor="#DBDBDB"><table width="100%" border="0" cellspacing="1" cellpadding="0"> <tr> <td width="53%" height="30" align="center" bgcolor="#FFFFFF" class="style2">Name &amp; Address of Employer </td> <td width="13%" align="center" bgcolor="#FFFFFF" class="style2">From<br /> (mo./ yr.) </td> <td width="12%" align="center" bgcolor="#FFFFFF" class="style2">To <br /> (mo. / yr.) </td> <td width="22%" align="center" bgcolor="#FFFFFF" class="style2">Designation</td> </tr> <tr> <td height="21" align="center" bgcolor="#FFFFFF"><input size="70" name="Emplyer_Name" id="Emplyer_Name" type="text" class="noborderfield" /></td> <td align="center" bgcolor="#FFFFFF"><input size="15" name="Emplyer_from" id="Emplyer_from" type="text" class="noborderfield" /></td> <td align="center" bgcolor="#FFFFFF"><input size="15" name="Emplyer_to" id="Emplyer_to" type="text" class="noborderfield" /></td> <td align="center" bgcolor="#FFFFFF"><input size="25" name="Emplyer_Designation" id="Emplyer_Designation" type="text" class="noborderfield" /></td> </tr> <tr> <td height="21" align="center" bgcolor="#FFFFFF"><input size="70" name="Emplyer_Name2" id="Emplyer_Name2" type="text" class="noborderfield" /></td> <td align="center" bgcolor="#FFFFFF"><input size="15" name="Emplyer_from2" id="Emplyer_from2" type="text" class="noborderfield" /></td> <td align="center" bgcolor="#FFFFFF"><input size="15" name="Emplyer_to2" id="Emplyer_to2" type="text" class="noborderfield" /></td> <td align="center" bgcolor="#FFFFFF"><input size="25" name="Emplyer_Designation2" id="Emplyer_Designation2" type="text" class="noborderfield" /></td> </tr> <tr> <td height="21" align="center" bgcolor="#FFFFFF"><input size="70" name="Emplyer_Name3" id="Emplyer_Name3" type="text" class="noborderfield" /></td> <td align="center" bgcolor="#FFFFFF"><input size="15" name="Emplyer_from3" id="Emplyer_from3" type="text" class="noborderfield" /></td> <td align="center" bgcolor="#FFFFFF"><input size="15" name="Emplyer_to3" id="Emplyer_to3" type="text" class="noborderfield" /></td> <td align="center" bgcolor="#FFFFFF"><input size="25" name="Emplyer_Designation3" id="Emplyer_Designation3" type="text" class="noborderfield" /></td> </tr> <tr> <td height="21" align="center" bgcolor="#FFFFFF"><input size="70" name="Emplyer_Name4" id="Emplyer_Name4" type="text" class="noborderfield" /></td> <td align="center" bgcolor="#FFFFFF"><input size="15" name="Emplyer_from4" id="Emplyer_from4" type="text" class="noborderfield" /></td> <td align="center" bgcolor="#FFFFFF"><input size="15" name="Emplyer_to4" id="Emplyer_to4" type="text" class="noborderfield" /></td> <td align="center" bgcolor="#FFFFFF"><input size="25" name="Emplyer_Designation4" id="Emplyer_Designation4" type="text" class="noborderfield" /></td> </tr> <tr> <td height="21" align="center" bgcolor="#FFFFFF"><input size="70" name="Emplyer_Name5" id="Emplyer_Name5" type="text" class="noborderfield" /></td> <td align="center" bgcolor="#FFFFFF"><input size="15" name="Emplyer_from5" id="Emplyer_from5" type="text" class="noborderfield" /></td> <td align="center" bgcolor="#FFFFFF"><input size="15" name="Emplyer_to5" id="Emplyer_to5" type="text" class="noborderfield" /></td> <td align="center" bgcolor="#FFFFFF"><input size="25" name="Emplyer_Designation5" id="Emplyer_Designation5" type="text" class="noborderfield" /></td> </tr> </table></td> </tr> <tr> <td colspan="2" class="bodyred">Declaration</td> </tr> <tr> <td colspan="2" class="body"><div align="justify">I hereby certify that all the information contained in this application is true and correct and I understand that CAE's University Placement Service (CAE-UPS) is relying on this certification in arranging my admission in an institute of higher learning in the United States of America / Canada.<BR><BR> I undertake to co-operate with Council for American Education (CAE) at all times. I will submit the required documents in the format to CAE as and when demanded. I have already secured or I will secure at least 90 in Internet based TOEFL (IBT) and the appropriate scores in Sat-I / GMAT / GRE.<BR><BR> I hereby authorize CAE to complete, sign and submit o my behalf any all documents and forms required to obtain acceptance to an institute of higher education in the Unites State / Canada and to receive direct notification of the results of the said application. Further, I understand that it is my responsibility to get the official scores of GRE/GMAT/SAT & TOEFL reported to the institution to which CAE is applying on my behalf. Also, if any credit evaluation is required either by the university or by CAE, I shall bear the expenses. The UPS charges paid to CAE do not include official score reporting, credit evaluation charges and courier charges. I also authorize Council For American Education to do the any necessary foreign exchange formalities on my behalf. <BR><BR> I understand that CAE s services are limited to university admission only and I agree that CAE has no liability to me whatsoever in connection with my enrollment in any institution of higher education including without limitation any claims for transportation, tuition fees and living expenses. I understand that CAE s standard package includes application to five universities and will hand over only one acceptance letter / I-20 to me. If a university required a deposit for the issuance of I-20, I understand that it is my responsibility to send the deposit to them to get the I-20. <strong>CAE s processing charges do not include application fee to any university, courier charges and visa application fees</strong>. I undertake to bear these expenses separately. If I would like to apply to more than five universities, then I agree to pay additional applicable charges to CAE. I further understand that it is not the responsibility of CAE to get my admission differed to any other semester / year. If CAE agrees to get my admission deferred (on my request) I will pay the required charges to them.<BR> <BR> FEES PAID TO CAE WILL NOT BE REFUNDED IF CAE IS UNABLE TO SECURE ADMISSION BECAUSE OF MY NON-COOPERATIVE ATTITUDE OR IF I DECIDE NOT TO PROCEED WITH THE ADMISSION PROCESS FOR WHATEVER OR IF I AM DENIED A STUDENT VISA. In case the student is entitled to a refund, only original amount paid to CAE will be refunded without any interest and penalties/ damage or nay other incidental charges incurred.<BR><BR> Although CAE will provide expert guidance for student visa application, it has no responsibility whatsoever for applying or obtaining a visa. 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