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Questionnaire

Personal
Name:
Date of birth:
Fathers Name:

Mothers Name:

Occupation:

Occupation:

Siblings(if any):
Age:
Currently pursuing:

Age:
Currently pursuing:

Common Admission Test Details


Percentile

Score

OVERALL
Data Interpretation
Quantitative
Verbal
Have you appeared for the CAT earlier:
If so, what was your percentile score(s):
Did you secure interview call(s) from the IIMs:
Apart From IIMs have you received any other calls? Pls Mention:

___________________

___________________

___________________

___________________

___________________

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Mentors Comments:

TARGET IIM

Write Your Biographical Sketch In One Page

Mentors Comments:

TARGET IIM

Academics
10th

Class
Class 12th
Graduation
Post Graduation
Professional
Qualification (if
any)

Question

Institutions

Years attended

Subjects

Marks (%)

Response

1. Elaborate on
your education
from class 10 till
12. What were the
reasons and
motivations behind
the choice you
made?

2. Give a brief
account of your
graduation,
including the
reasons for your
choice, preferred
subjects etc.

Mentors Comments:

TARGET IIM

3. Is there any gap


in your education?
If so, please
elaborate

4. Academic
achievements
(Scholarships etc.)

5. Overall, how
would you rate
yourself as a
student?

Mentors Comments:

TARGET IIM

Work Experience
Total work Experience (in months) as on 01/01/2010(Paid & Full Time After Graduation):
Organization

Position

Mentors Comments:

Period

Responsibilities

Achievements

TARGET IIM

Extra-Curricular Activities/Sports
1. During school

2. During
Graduation

3. Hobbies and
Interests / What
you generally do in
free time?

4. How would you


relate the above
mentioned
interests to what
you want to do in
life?

Mentors Comments:

TARGET IIM

Community/Social Service
Activity -1
Year(s) of participation

Responsibilities

Achievements

Activity -2
Year(s) of participation

Responsibilities

Achievements

Mentors Comments:

TARGET IIM

Strengths
For your self-assessed strongest 3 strengths, provide an instance of how this strength came to your
use/need
Strength 1
Quote an instance
where you used your
strength

Strength 2
Quote an instance
where you used your
strength

Strength 3
Quote an instance
where you used your
strength

Mentors Comments:

TARGET IIM

Weaknesses
Please list any 3 areas that you perceive to be a weakness for you.
Weakness 1
When did you identify it
How is it hampering your
professional/personal life
What are you doing to
overcome it
Weakness 2
When did you identify it
How is it hampering your
professional/personal life
What are you doing to
overcome it
Weakness 3
When did you identify it
How is it hampering your
professional/personal life
What are you doing to
overcome it

Mentors Comments:

TARGET IIM

Career Vision
Question
1. What are your
career goals?

Response

2. Why do you want


to pursue an MBA?

3. Whom do you
admire the most, and
why?

4. Tell us about a
time when you went
beyond what was
defined, expected or
established?
5. Tell us about a
time when you made
a difficult decision?

6. Describe the worst


team experience you
have ever had. What
did you do?

Mentors Comments:

TARGET IIM

Miscellaneous
Question

Response

1. What matters most


to you and why?

2. What have you


learned from your
costliest mistake?

3. Discuss the most


critical feedback you
have received.

4. What do your
friends think about
you?

Mentors Comments:

TARGET IIM

5. Which recent
development
has
most influenced your
thinking and why?

6. Tell me about
something that you
did, or failed to do,
that you regret

7. How do
handle stress?

you

8.
Apart
from
management which
other career option/s
interest you?

Mentors Comments:

TARGET IIM

Values and Beliefs


Question
1. What does success mean to
you?

Response

2. Suppose you are an


insurance agent whose friend
is dying of cancer. Knowing
that you can help him and his
family, would you clear his
medical certificate so that he
can get life insurance from
your company?

3. Suppose you are playing for


the Indian cricket team. You
are the last batsman. The team
requires two runs to win.
Suddenly you nick the ball and
the keeper catches it. The
opposing team appeals. But
the umpire is not sure if you
have nicked the ball. He asks
you. What would be your
answer?

Mentors Comments:

TARGET IIM

Mentors Appraisal of Candidate


Mentor:
Contact No:
1.
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2.
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3.
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4.
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5.
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Mentors Comments:

TARGET IIM