INDIAN INSTITUTE OF MANAGEMENT RANCHI

POST GRADUATE PROGRAMME IN MANAGEMENT

Application Form for the Batch 2010 – 2012

Affix a recent
passport size
photograph

Name:

Category (Tick): General NC-OBC SC ST DA+ (If NC-OBC, SC, ST or DA,

attach necessary certificates)

Date of Birth (DD / MM / YYYY): Voucher No.:

CAT Registration No./Prometric Testing ID: SR CAT Score: Percentile

Test Date: Test Time: Test Site Code:

Current Mailing Address:

Pin Code:

Landline No.: Mobile No.:

E-mail ID:

Date: Candidate’s Signature:

___________________________________________________________________________
+ Differently Abled

N.B.: This Application Form should be completely filled in and sent to Admissions Office, Indian Institute of
Management Calcutta, P.O. Joka, Diamond Harbour Road, Kolkata 700 104, W.B. latest by 31st
March, 2010. Incomplete application forms or application forms not received by the due date will not be
considered.