Form No.

INDIAN INSTITUTE OF MATERIALS MANAGEMENT

Stamp size
Course: _____________________________________________________________ photograph to
be attested
dully signed
Roll No. :___________________________________________________________ across
(For IIMM use)
CHOICE OF EXAM CENTRE :
(Select from the prospectus)
1. Name of the applicant (in BLOCK LETTERS, as in 10 +2 mark sheet/UG/PG/PG Diploma certificate)

2. Father’s Name

3. Date of Birth Day Month Year

4. Sex: Male Female 5. Nationality

Indian Others
6. IIMM Membership No. …………………………………………….

7. Student’s E-mail ID: ___________________________________________________________________

[If he/she has this facility]
8. Address to which communication is to be sent: (Name not to be mentioned) (in BLOCK LETTERS)
Line 1
Line 2
Line 3
Line 4
Pin code Phone :
STD Code
9. Office Address:
Line 1
Line 2
Line 3
Line 4
Pin code Phone :
STD Code

10. Educational Qualification (Attested copies must be enclosed)

Degree/Diploma Year of Passing % Marks University/Institute
11. Experience Profile (please mention from current job title) (Attested copies must be enclosed)
Organization Job Title Period
From TO

12. How did you get to know about IIMM COURSES?

Newspaper Website Friends Others (Pl. Specify)

13. Elective paper (for PGDMM Course only)

Declaration
I declare that all the information submitted in this application form is correct and complete. I
acknowledge that the IIMM reserves the right to vary or reverse any decision regarding admission on the
basis of incorrect or incomplete information provided by me.
I declare further that I had read & understood all contents of this application form & information
Brochure and that I am bound by all their contents for all purpose.

Date : Signature of the Candidate

…………………………………………………………………………………………………………………

For IIMM Use

Aptitude Test Details (only for GDMM/PGDMM & PGDLM courses)

Max. Marks Min. Marks Marks obtd. Admitted Yes ……… No…….
Aptitude Test 100 50
Viva Voce 100 50 Signature of Course Coordinator

This form, together with supporting documents should be sent to:

The Course Coordinator of the IIMM Branch for admission.

Check List: (put tick √ mark)

1. Statement of Marks (Xerox Attested)
2. Degree Certificate (Xerox Attested)
3. Provisional certificate
4. Work experience Certificate (Xerox Attested )
5. Filled-in Identity Card duly signed with photograph
pasted
6. DD for Rs.200/- towards CAT fee
for GDMM/PGDMM & PGDLM courses only)

For details contact:

DIRECTOR - EDUCATION
INDIAN INSTITUTE OF MATERIALS MANAGEMENT
NHQ EDUCATTION WING
102, & 104 Institutional Area, Sector 15, CBD Belapur, Navi Mumbai - 400 614
 Ph. : 91-22-27565741, 27571022 Telefax : 91-22-27565592
E-mail : iimmedu@mtnl.net.in

Note:
Candidates should enclose the D.D. of Rs 550/- in favour of IIMM NHQ
Collection A/c payable in Mumbai while applying. (The hard copy of prospectus
with application form will be mailed to him on receipt of the D.D)