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CIML Business School

ware, Uni
Dela
Delaw
Unitted States of Ameri
Americca

ATION FORM
APPLIC
APPLICA
State/country where applied from........................................
Programme of Study.......... Specialization.......
Awarding University .........................................................................................
Name of Student........................................................
Date of Birth............. Sex Marital Status.
ADDR
ADDREESS
SSEES:
Permanent home address:...........
....................
Address for Correspondence (if dif
diffferent from home add
addrress)
ess)....

....

....
....

Postal Code:....... Tel:....................................................... Fax:............


Email:................................................................................................................
DY
METHOD OF STU
TUD
Full time or Part time Through our affiliate Centers
Online
(Particula
articularrs of Educ
ducaation)
School, College or other Secondary
Institutions Attended

Date
Qualification/Certificate Obtained
From

To

The Chartered Institute of Management and Leadership Business School is an education and training arm of Chartered Institute of Management and
Leadership duly incorporated and chartered under Delaware Code, Title 6; Chapter 18 of the state of Delaware statues

University, Polytechnic, College or other


Higher Institutions Attended

Degree, Diploma,
Professional Qualification
Obtained

Course of Study

Date of Award

UAGE COMPETENCE
ENGLISH LANG
LANGU
a. Is English your first language?
b. Is/Was English the language of instruction of your first degree?
c. Please list any formal English Language qualifications with results obtained (IE
(IELLTS, TOEF
OEFLL, GCE, GCSE, ELSE)
and the dates you took the test, or will be taking the test.
English Qualification:

Result:

Date:

(Emplo
nt hi
(Employyme
men
hisstory)

Current Occupation

Employer

Position Held - Title

Duties in Brief

Period of Service

Finding out about CIML Business Schoo


Schooll:
How did you first learn about your proposed programs of study at CIML Business School, USA?
All applicants should note that the Institute reserves the right to make without notice changes in regulations,
courses, fees etc at any time before or after a candidate's admission. Admission to the Institute is subject to the
requirement that the candidate will comply with the Institute's registration procedure and will duly observe the
Charter, Statues, Ordinances and Regulations from time to time in force. Programme & Application fees once
paid are not refundable.

The Chartered Institute of Management and Leadership Business School is an education and training arm of Chartered Institute of
Management and Leadership duly incorporated and chartered under Delaware Code, Title 6; Chapter 18 of the state of Delaware statues

Decla
Declarration from Appli
Appliccant
I am willing to apply for aforesaid course of Chartered Institute of Management and Leadership Business
School, USA and for the same I am submitting this form through the authentic study center of the Institute.
All the information provided above in the form are true to the best of my knowledge.
I have confirmed the affiliation status of the study center through the official website of the Institute
(www.cimlglobal.us), the name and link of the study center is present in the list of Global Affiliates of the
institute.
CIML Business School maintains its global accreditations, affiliations, and recognition as per its management
decisions and is not focusing on any country specific accreditation/recognition. I, the applicant, would be
solely responsible for acceptability of the earned certificate in the region of use.
I would abide by the rules and regulations of the Institute failure in which the institute may take disciplinary,
legal, or formal actions as the case may be. Decision of the Management of the institute would stay final in
all cases.

Sign
nt:
......
Date:
............

.........

..
Signaatu
turre of Applica
Applican
......
......
............
............
.. Place:
.........
.........

Decla
Declarration from Nomin
Nominaator
As on date, I am an authentic affiliate/nominator of the Institute and the status of my affiliation with CIML is
available on its official website of the Institute (www.cimlglobal.us). The same has been shared with the
applicant.
I have confirmed the identity and eligibility of the applicant. All the information provided above in the form is
true to the best of my knowledge.
I am nominating the applicant for aforesaid course of Chartered Institute of Management and Leadership
Business School, USA and for the same I am submitting and signing this with the applicant.
I have seen all original documents and have put the attested photocopies of all documents in my records.
I would maintain the application records, study records, and performance record of the candidate in my safe
repository and will provide to the Institute if demanded anytime in future (up to 10 years).

.....
Date:
...

Sign
Signaatu
turre and Stamp of Nomin
Nominaator:
.....
.....
...
...
..
nts to be at
Docume
Documen
atttached with this form:
1. Two passport size photographs
2. Attested photocopies of all educational certificates (10th onwards)
3. Address Proof (Electricity Bill/Mobile Bill/Driving License/Credit Card Statement in the name of candidate only)
4. Identity proofs (some document issued from State/Central Government only, like Passport/Driving License etc.)
5. A detailed resume of the candidate
6. Attested photocopies of work experience certificates
The Chartered Institute of Management and Leadership Business School is an education and training arm of Chartered Institute of Management and
Leadership duly incorporated and chartered under Delaware Code, Title 6; Chapter 18 of the state of Delaware statues