APPLICATION FORM: -

Course Name

Specialization

Counselor Name City: ________________

Applicant Details:

Name:

D.O.B. Male: Female:

Married: Unmarried: Nationality:

Father’s/ Husband’s Name:

Mother’s Name:

Correspondence Address:
Permanent Address:

Tel. No.: (M)

(R)

(O)

E-mail:

Academic Details:
Qualification Board/University Passing Year/Month Grade Specialization if any

Work Experience:
Company name City/State Designation No. of Years Remarks

Exam Option: From Home Study Center E-mail:

Declaration by Applicant:
I declare that I have understood the norms of Indian Institute of Business Management and Studies. I
assure that I will abide by the conditions and standards of the institute. I am fully aware that if I am
found violating any conditions then my admission may be cancelled and I will be entirely responsible
for it.
Date:
Signature:

For Institute’s Use Only:

Fee Paid: Mode Of Payment:

Xerox Copy of Mark Sheets and Certificates in proof of all examination passed should be attached.
The Application form along with the Bank Draft should be sent to the Institute through Courier/ Speed Post.
For more than one application Xerox copy of this application proforma can be used.
Please Keep a Xerox copy of this application proforma for your record and reference.
Fee once paid is not refundable under any circumstances.