New Delhi Institute of Management

Paste your
current
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Application Form
(To be filled in block letters)

2 Yr. PGDM

2 Yr. PGDM (Marketing)

First Name

Middle Name

2 Yr. PGDM (Finance)

Surname

Male/Female (Please tick)

Nationality ________________________

Date of Birth _________________________

Fathers Name & Occupation: __________________________________________________

____________________________________________________________________________
Mothers Name & Occupation: _________________________________________________
____________________________________________________________________________

Category (General/SC/ST/OBC/PH):______________________________________
Correspondence Address:
_____________________________
_____________________________
_____________________________

Permanent Address:
_____________________________________
_____________________________________
_____________________________________

PIN: ________________________

PIN: ________________________________

E-mail:

E-Mail of parent/guardian: _____________

Tel _______________________

Tel of parent / guardian ____________

New Delhi Institute of Management

Confidential

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Academic Record:
Examination
passed

Name of
Board /
University

Name of
School/
College

Degree/
Specialiation

Division

Percentage
of marks

Medium
of
Instruction

Year of
Passing

10+2
Graduation
Post
Graduation
Professional
Any other

Scholarships & Awards:

Title of Scholarship/Award

Year

University/College/Institution

Please provide references of 3 persons close to you / your family (This is optional)
Name & Designation & Address

Phone & e-mail

Work experience, if any:

Period

Designation

Organization

Email/phone of
HR at the organization

Other Specialized Skills/Achievements/Interests:

________________________________________________________________________
________________________________________________________________________

New Delhi Institute of Management

Confidential

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Name of Entrance
Examination (CAT,
MAT, CMAT, XAT
etc.)

Registration
Number (CAT,
MAT, CMAT, XAT
etc.)

Year

Score

Percentile

Why do you want to join NDIM (please use additional sheets, if necessary)
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Do you require Hostel accommodation?

Yes

No

DECLARATION
I declare that the information furnished above is correct. I accept that incorrect
information or withholding of relevant information may disqualify me. I agree to abide
by the rules and regulations of the Institute.

.
Date

Applicants Signature

INSTRUCTIONS TO APPLICANT

Form should be filled in bold letters or type-written and sent at following address.
It should be sent along with 2 passport size photographs, photocopies of 12th and
graduation marksheets, and self-attested copy of MAT/CAT/CMAT/XAT/ score
card.
Also enclose a demand draft/ pay order of Rs. 1050/- in favour of New Delhi
Institute of Management, payable at New Delhi
New Delhi Institute of Management
50 (B&C), Tughlakabad Institutional Area
New Delhi-110062
Ph : 011-40111000, 2995666/67/68/69

New Delhi Institute of Management

Confidential

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