(Please read instructions carefully before filling up the form) FIRST NAME LAST NAME MIDDLE NAME



Below Higher Secondary Yes

Higher Sec / Technical Diploma No


Post Graduate




OCCUPATIONAL DETAILS OCCUPATION Student Self Employed Service Others ____________________(pls specify)







 Financial Markets: A Beginners' Module  are available in English.) Mutual Funds : A Beginners' Module Currency Derivatives: A Beginner's Module Equity Derivatives: A Beginner's Module Interest Rate Derivatives: A Beginner's Module Securities Market (Basic) Module Capital Market (Dealers) Module English Gujarati   For Office Use only Hand Del/ Courier Mails of the Day Chkd/Reg. PART‐III   PAYMENT DETAILS DD NUMBER 1 DD NUMBER 2 DD NUMBER 3 DD DATE ( DD‐MM‐YY) ‐ ‐ TOTAL DD AMOUNT ISSUING BANK (NAME AND BRANCH) I certify that the above information provided by me is true and correct to the best of my knowledge.  Test fees are valid for 180 days from the date of payment.  Please tick the appropriate language.   Candidates need to enroll for the test(s) within 180 days from payment of fees. the test cannot be rescheduled Fees once paid shall not be refunded./Scanned Enrollment/DD Entry SM Issued/SM Sent Derivatives Market (Dealers) Module English Gujarati  FIMMDA‐NSE Debt Market (Basic) Module Surveillance in Stock Exchanges Module Corporate Governance Module Note:   Test in Capital Market (Dealers) Module.NATIONAL STOCK EXCHANGE'S CERTIFICATION IN FINANCIAL MARKETS (NCFM) (Please read instructions carefully before filling up the form) Page 2 PART‐II TEST DETAILS NCFM‐  MODULE NAME (Tick the desired Module) Financial Markets: A Beginners' Module English             Gujarati Hindi Compliance Officers (Brokers) Module Compliance Officers (Corporates) Module Information Security Auditors Module (Part‐I) Information Security Auditors Module (Part‐II) Commodities Market Module NSDL‐ Depository Operations Module Options Trading Strategies Module Investment Analysis and Portfolio Management Module Hindi Commercial Banking in India: A Beginner's Module Fundamental Analysis Module Hindi Banking Sector Module Insurance Module Macroeconomics for Financial Markets Module Financial Modeling Module (specify registration number. information and belief. Gujarati and Hindi languages. Derivatives Market (Dealers) Module. if already registered under NCFM. PLACE DATE ‐ ‐ 2 0 (CANDIDATE'S SIGNATURE) . PREFERRED TEST CENTRE (mandatory) TEST SCHEDULE TEST CENTRE  TEST DATE ‐ ‐ Y Y Y H H TEST TIME : M M D D M M M Y Once the test details has been specified by the candidate.

The list of the candidates who have been enrolled will be displayed on the Test Center National Stock Exchange of India Ltd. Fill in your DATE OF BIRTH in the following format :. before you send it to NSE.500029 (Landmark . Forms can be sent by courier / post to any of the NSEIL offices. Bandra (East).INSTRUCTIONS FOR FILLING-UP REGISTRATION FORM 1 Please fill in all details in the entire form only in BLOCK LETTERS.: (011) 23344313-27 Fax: (011) 23366658 e-mail: ncfm_delhi@nse. Chennai-600034 6000034 (Landmark . Garden. Kanjurmarg (West).Road. as per the given curriculum. Mani. 23 MAR 1974) Name to be Printed on Certificate will be printed same as 'First Name Middle Name Last Name'. As per Hazra Road. and National Stock Exchange of India National Stock Exchange of India Ltd. Bandra-Kurla Complex. Please fill in the First Name. Sterling Road Bus Stop.. Basheerbagh Square) Tel: (040) 23227084/5 Fax : (040) 23227086. Metro Station) Tel.700019 (Landmark . Kaveri Complex ( Ground Floor). then you would be allowed to take the test only on furnishing a passport size photograph and an attested copy of a photo-id proof (attestation by Gazetted Officer).in Any other centre (depending on demand) visit our website: nseindia. e-mail: ncfm_hyderabad@nse. Sakar II. E.50/. Please mention Test Center. Door NSEiT Test Center. Please visit the website for complete details. Tel No: 022-22047569. Park View Apartments.G.110001 (Landmark . United India Write only one alphabet in each square provided. 99. tests cannot be rescheduled / postponed. Please mark your envelopes as 'To NCFM Department'. Fax: (022) 26598393 E-mail : ncfm@nse. LBS Marg. Please tick the box of the module you wish to appear. Hyderabad . pincode & state.nseindia. Fort. Mumbai . Please refer the format given on the website under off-line registration procedure. 96-104.G. 1st Floor. manuals Please write the name of the candidate on the reverse of the demand draft. Near Ellis Bridge. the duly filled up form with requisite payment can also be put in a drop-box kept at the main entrance at the Bandra-Kurla office. Leave one square blank between Time Slots (in hours) 9:30. Sapphire Complex. Apna Bazaar. Metro Station) Tel. Hazra Law College availability / HDFC Bank Building) 6 National Stock Exchange of India Ltd. 28332511. 15:45 3 National Stock Exchange of India Ltd.. Fees to be paid by Demand Draft in favour of 'National Stock Exchange of India Limited’. Basheerbagh. Near Bodyline Char Rasta. 13 Jolly Makers Chambers -II. 2nd Floor. The original photo id proof would be required to be shown at the time of the examination. No study material will be provided for the Compliance Officers Modules.: (044) 28332500/ NSEiT Test Center. 11:30. Exchange Plaza. 406.. Nungambakkam High Road. B) Western Indian Regional Council (WIRC) of the ICSI.Next to Income Tax Office / CA Institute) Tel. 54/1/A. Near G. Opp Times Square. Candidates need to enroll for the test(s) within 180 days from payment of fees.400001 (Landmark . 101. C. 13:45. Compliance Officers Modules & Financial Modeling Module) will be sent to you by courier in SEVEN working days from date of payment.203 & payable. Mumbai 400021. Near Ellisbridge) Tel. Please note that study material will NOT be provided in case of balance payment being made. No. 1st Floor. CBD Belapur.Nungambakkam High Road. Opp. Above GKB Opticals). The details of NCFM modules are given in the next sheet Fees once paid shall not be refunded. e-mail: ncfm_ahmedabad@nse.110001 (Landmark . Institutional Area. New Delhi .Road) As per availability As per availability 4 5 NSEiT Test > ncfm> testing > test at other locations 7 . Basheerbagh. At the time of the test.16 Extn. email: ccrt@icsi. Akruti Corporate Park. Chennai . Middle Name. You are required to paste a recent colour passport size photograph in the space provided. Do not sign across the photograph. Do not staple the photograph. Kolkata – 700029 (Landmark Deshpriya Park. In case of Mumbai office. Also keep a photocopy of the demand draft with you. Mahavir House. H 15:30 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 1 2 9:45. if it is seen that the photograph has not been Navi Mumbai-400614 #022-27577814 . Tel. Please fill in the qualification and occupation details as may be applicable. Jeevan Vihar Building. candidates are required to refer to the relevant books. e-mail: ncfm_chennai@nse. ccrt@vsnl.500029 Near Liberty Cross National Stock Exchange of India Ltd. Fax : (044) 28332521 . As per availability IInd Floor. (033) 40400440. Plot No. Test date and time may be submitted as per your choice and as per the availability at each test center. Near Priya Cinema. NSEiT Test Center. Ahmedabad-380019 (Landmark . The study material of all modules (except for Corporate Governance. No. e-mail: ncfm_kolkata@nse. Indian Bank) National Stock Exchange of India Ltd. Last Name and Date of Birth mandatorily. Kindly contact NCDEX. Nav-Jeevan Apartments. Parliament Street. circulars. 1st Floor.. 401.. Kolkata . Form submission by hand delivery at all NSEIL offices is on Mon-Fri between 10:00 am to 5:00 pm only.DD-MMM-YYYY (e. Ispahani Centre. Tel No: 022-66406789 Study Material for the Corporate Governance module is available for sale at ICSI offices at: A) ICSI-Centre for Corporate Research & Training. on their own. (033) 24631802/40 400 400 Fax.380006 (Landmark . 3-6-363..C. On-line registration is also possible on www. payable at the nearest NSE office. The NCFM registration forms can be sent to the following NSE offices: NSE Office National Stock Exchange of India Ltd. Mumbai .: (011) 23344313-27 Fax: (011) 23366658 e-mail: Please mention full contact details with city. Scorecard: Scorecard is issued on the spot to the candidate after the completion of test (only if photograph is uploaded).400051 Tel: (022) 26598216. Nungambakkam. 500/.: (079) 26580212/3 Fax: (079) 26576123. Sector courier charges. Nungambakkam. Nariman Point. Chamber no.Near Police Commissioner's Office. Also once enrolled. Town Hall.Near Bodyline Char Rasta. 4th Floor. 123-124. 406. Contact Person: Mr. For subsequent requests for scorecard a demand draft of Rs.Near Patel Chowk.. In the space provided for TEST DETAILS (Part-II). First Floor. Sign in the block provided for signature. Fees : (see Module table given in next sheet) Please note that test fees once paid are non-refundable.400078 office for this training material. Jeevan Vihar Building. 3rd Floor. 303-304. Near Kashmir Emporium.on Sat also)./mobile no. Parliament Street. Please note that the NCFM tests are conducted at the mentioned test centers from Monday to Friday only (at Mumbai . Sir Phirozeshah Mehta Road. 2nd Floor. Rash Behari This service is free of charge. Opp. NCDEX distributes the training material of Commodities Market Module free of cost only to their active members and to others at a cost of Rs. New Delhi . Hyderabad . Mahavir Chambers..g. email: wiro@icsi. (In case of Ahmedabad it is between 10:00 am to 4:00 pm).co. Test date can be informed by e-mail or fax. Test fees are valid for 180 days from the date of payment. Ahmedabad . Please specify your telephone In case of Compliance Officers Modules. Mumbai . 4th Floor.Opp. 4th Floor.Near Patel Chowk..

## Modules of Finitiatives Learning India Pvt. of Pass Max Marks Validity (in Fees (Rs.Depository Operations Module Commodities Market Module Surveillance in Stock Exchanges Module Corporate Governance Module Compliance Officers (Brokers) Module Compliance Officers (Corporates) Module Information Security Auditors Module (Part-I) Information Security Auditors Module (Part-II) Options Trading Strategies Module FPSB India Exam 1 to 4 *** Examination 5/Advanced Financial Planning *** Equity Research Module ## Issue Management Module ## Market Risk Module ## Financial Modeling Module ### Duration (in mins) 120 120 120 120 120 120 105 105 120 120 120 120 120 120 120 75 120 120 90 120 120 120 120 120 120 240 120 120 120 150 Certificate No. No.e. (i) Risk Analysis & Insurance Planning (ii) Retirement Planning & Employee Benefits (iii) Investment Planning and (iv) Tax Planning & Estate Planning Examination 5/Advanced Financial Planning # Candidates securing 80% or more marks in NSDL-Depository Operations Module ONLY will be certified as ‘Trainers’. Ltd. (FLIP) ### Module of IMS Proschool . NAME OF MODULE 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 Financial Markets: A Beginners' Module* Mutual Funds : A Beginners' Module Currency Derivatives: A Beginner's Module Equity Derivatives: A Beginner's Module Interest Rate Derivatives: A Beginner's Module Commercial Banking in India: A Beginner's Module Securities Market (Basic) Module Capital Market (Dealers) Module* Derivatives Market (Dealers) Module* FIMMDA-NSE Debt Market (Basic) Module Investment Analysis and Portfolio Management Module Fundamental Analysis Module Banking Sector Module Insurance Module Macroeconomics for Financial Markets Module NSDL . *** Following are the modules of Financial Planning Standards Board India (Certified Financial Planner Certification): FPSB India Exam 1 to 4 i.LIST OF MODULES Sr. Gujarati and Hindi languages.) Questions Marks (%) yrs) 60 100 50 5 1500 60 100 50 5 1500 60 100 50 5 1500 60 100 50 5 1500 60 100 50 5 1500 60 60 60 60 60 60 60 60 60 60 60 60 50 100 60 60 90 90 60 75 30 65 80 50 50 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 140 100 100 100 100 75 50 60 50 60 60 60 60 60 60 60 60# 50 60 60 60 60 60 60 60 60 50 55 55 55 50 5 5 5 3 5 5 5 5 5 5 5 3 5 5 5 5 2 5 NA NA 2 2 2 NA 1500 1500 1500 1500 1500 1500 1500 1500 1500 1500 1500 1800 1500 1500 1500 1500 2250 2250 1500 2000 per exam 5000 1500 1500 1500 1000 * Candidates have the option to take the test in English.

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