INDIAN BUSINEES SCHOOL OF MANAGEMENT

PLOT NO. 17A, GURUDEO NAGAR , NANDANVAN, NAGPUR

Mob. 09822924273,08055937010
Email:ibsmnagpur@rediffmail.com

website: http://www.ibsm.org.in

1) Name of Candidate:
2) Gender: Male

Female

3) Date of Birth:

Paste Passport
Size Photograph

4) Fathers/Husbands Name:
5) Address for communication:

6) State:

Pin Code:

7) Phone No. (With Code):

8) Mobile No.:
9) E-Mail Id:
10) Academic Qualification:
11) Whether employed or not:
12) If yes, specify the name and place of organization:
13) Examination Method Preferred:

Postal Based

14) Courses Selected:

1.
2.
3.
15) Elective Selected:
1.
2.
3.
16) Opted Fast Track:

Yes

No

Email Based

Centre Based

17) Payment Mode:

Lump sum Payment Scheme

Installment Scheme

18) Course Fess:

I st Installment Fee along with application form:
II nd Installment

I II rd Installment

DD No. and Date

Name of Issuing Bank

Check List:
Application form properly filled and signed.
Graduation / 3 rd year Mark Sheet / Diploma Certificate
Experience certificate from current employer
CV (Bio-Bata)
4 passport size photograph
Demand Draft (Write your name, contact no, place and course offered.
DECLERATION
I have read and understood the rules and regulation of IBSM (Indian Business School of
Management) in the prospectus and I do here by agree to abide by the same.
Place:
Date:

Signature
Rules and Regulation of the Institute
I.

II.

III.

IV.

V.

The director of the institute reserves the right to accept or reject and application form
without assigning any reason what so ever.
The necessary fee by DD drawn in a favour of Indian Business School of Management
payable at Nagpur will have to sent along with filled up application form.
No refund or adjustment of fee paid other than mentioned in the prospectus shall be made
under any circumstances. In case of the rejection of an application form, full fee paid will
be refund.
Allotment of the examination centre in a particular place will at the direction of the Board
of Examinations of the Institute the right to cancel any centre if there insufficient number
of students.
The management of IBSM reserves the right to change the course details without notice as
per the prevailing conditions.

VI.

All disputes subject to Jurisdiction of Court in Nagpur city only.