T A X I L A

TAXILA

BEYOND EDUCATIONBEYOND EDUCATION

Taxila Business School

AB-559, Kings Road, Nirman Nagar, Jaipur, RajasthanTel: 0141-6500000, 09602099999, 09314487771, 09314487772.email: info@taxila.in, www.taxila.in

Application form for Executive Education

Dear Business Leader,You are very important to us.At the outset we thank you for the interest

shown in our programs. We have exceptionallyhigh standards for the talent that we take in to our program. Superior leadership qualities,communication and interpersonal skills, commitment, problem- solving ability, Value drivenmindset, professionalism, flexibility, motivation and sharp intellectual curiosity are expected.Please read the instructions carefully before you begin to complete your application. You shouldfill in the application form in your clear and legible handwriting.•You are advised to keep a photocopy of the complete application form.•Incorrectly filled, incomplete or unsigned forms are liable to be rejected.•Taxila Business School (herein after called as Taxila) does not take anyresponsibility for delay or loss of the material in post / transit.Kindly attach a Demand Draft of Rs.6000/0 towards the Registration Fee favouring TaxilaBusiness School payable at Jaipur.

Admission TeamTaxila Business School

First nameLast nameDate of birth NationalityMarital status Gender:

PERSONALINFORMATION

Company nameCompany sector

(Telecommunications, Consulting, Financial Services etc).

Present positionFunctional area (Marketing, Finance, Operations, etc.)Company addressPhoneFaxE-mail May we contact you at this address? yesnoTotal number of consecutive years of full-time work experience at the start of the program:

EMPLOYERINFORMATION

(Please attach acurrent resume)

Program Applied For: I. MBA+EPGDBM2 yearsII. EPGDBM1 yearAny other( Please Specify:) _____________________________

COURSEAPPLIED FOR

AddressCity State PIN CodePhone Mobile FaxE-mailPermanent address, if current address ceases to apply:

MAILING ADDRESS

Please list all colleges and universities attended.

Year of passingBoard/ University%ageCert/ degreeXXIIGraduationAny Other

EDUCATIONALDETAIL

(Please attach thephotocopies of marksheets with the form)

Grades

BEYOND EDUCATION

PHOTO

Signature

SELFASSESSMENT

Please provide a critical self-assessment about yourself

YOUR PROFILE

Please describe your present or most recent position and its significance within the organization.

WORKEXPERIENCE

Please list your professional experience (including military) starting with the most recent.

Company

Title / Position

FromToCompanysectorAnnualSalaryNo. Of Years

FEE PAYMENTDETAILS

Mode of Payment : Company sponsoredBy own means

Please mention your payment or notification of bank transfer in the application form, and specify below yourmethod of payment (bank transfer, cheque, or demand draft) and should be payable to Taxila Business School .CashChequeName of the bank Cheque No. DatedDemand DraftName of the bank D.D. No. Dated

BEYOND EDUCATIONBEYOND EDUCATION

Signature