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1. 2. TWO YEAR (FULL TIME) POST GRADUATE DIPLOMA IN MANAGEMENT (PGDM) : 2012-2014 TWO YEAR (FULL TIME) POST GRADUATE DIPLOMA IN MANAGEMENT (PGDM) : FINANCE 2012-2014
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Instruction for filling form: i Fill in the application from in capital letters. The form should be complete in all respects. ii iii iv v vi Please do not enclose any testimonials alongwith the form. All Originals certificates should be produced at the time of interview. Incomplete forms will not be considered. Last date for receipt of application form: 12th December 2011. Mail the completed application form in the envelope provided. Tick ( ) in the correct box properly
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Name: Mr./Ms.. (CAPITAL LETTERS) (As given in 10th Certificate) Date of Birth 3. Sex : Female
Mailing Address.. . ..Pin Phone Landline:... Mobile: E-mail . (As provided in the CAT form) (Please type your e-mail on a paper strip and paste here)
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(i) Nationality (ii) Domicile State... Please give your preference by writing 1 & 2 in the appropriate boxes: PGDM Please tick mark : KASHMIRI MIGRANT * GENERAL PGDM-FIN
Category (Please tick any one) CAT - Registration No. (Allotted by IIM)
General
Corporate Sponsored
Both
(P.T.O.) 12. Details of Parents : Fathers Name.. Occupation Official Address.. . Phone/Fax.. 13. Academic Qualifications
EXAMINATION STREAM YEAR NAME OF SCHOOL/COLLEGE/UNIVERSITY BOARD/UNIVERSITY % OF MARKS OBTAINED
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Graduation (B.A, BSc etc) Post -Graduation Any Other 14. Academic Awards/Medals/Prizes/Scholarships/Honours etc. .. . 15. Extra Curricular Activities/Hobbies . .. . 16. Work Experience, if any:
ORGANISATION DESIGNATION FROM TO MONTHLY SALARY
Declaration
I have read the information brochure and agree to follow all the terms and conditions given therein. All entries made in this application form are true to the best of my knowledge and belief. I will produce original certificates at the time of interview. My candidature can be cancelled at any stage, if any information given is found to be untrue.
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