PGDM Admission Form_2012-14


Published on

Published in: Business, Education
  • Be the first to comment

  • Be the first to like this

No Downloads
Total views
On SlideShare
From Embeds
Number of Embeds
Embeds 0
No embeds

No notes for slide

PGDM Admission Form_2012-14

  1. 1. Plot No.5, Rao Tula Ram Marg, Vasant Vihar, New Delhi-110057Tel: +91-11-47285000/48/41/11, , Fax: 011-26144279, Email: Website: SL. No. Entrance Exam Details CAT --------------------------- Score--------------------------------- Affix your recent MAT----------------------------Score--------------------------------- Passport size Photograph Other-------------------------- Score--------------------------------- Attach an attested copy of Scorecard A. Personal Data 1. Full Name Mr. /Ms. ADMISSION FORM2. Date of Birth DD MM YY3. Current AddressCity PIN CodeStateApplicant’s MobileE-mail 1
  2. 2. 4. Permanent AddressCity PIN CodeState5. Father’s NameFather’s Profession6. Mother’s NameMother’s ProfessionFather’s/Mother’s Mobile B. ACADEMIC QUALIFICATION S. Degree/ Board/ Year of Percentage No. Certificate University College Name Specialization Passing / Grade ADMISSION FORM 1. 10th 2. 10+2 10+2+3 Bachelors 3. Degree* (Specify) Post Graduate** 4. (Specify) Any Other 5. (Specify)* Select relevant one for Bachelors Degree--B.A., B.Com. B. Pharma, B.E., B.Tech., B.Sc** Select relevant one for post Graduate Degree-- M.A., M.Sc., M.Com., M.E. etc.Note:a) OVERALL PERCENTAGE OF MARKS MUST INCLUDE ALL SUBJECTS.b) If you are awarded a grade point please convert them into percentage of marks and indicate.c) If there is a formula given by University for conversion it may please be stated.d) If you are a rank holder, indicate the same with class awarded.e) * If yet to be completed, please give us the details of your present status and percentage / grade scored till your last semester / year.
  3. 3. C. CORPORATE EXPOSUREWork Experience (if any): Period Last Salary Name & Address of Nature of Work Drawn Organization Designation From To (Rs./ Month)TOTAL EXPERIENCE (IN YEARS) D. AWARDS & HONOURSAcademic/ Professional Awards/ Medals/ Prizes/ Scholarship/ Certificate/ Honours, etc. Level (State / National/ Remarks Year Name of Award Awarding Institution International ) ADMISSION FORM E. MISCELLANEOUSMajor Extra-Curricular Activities: Year Activity Role Level Remarks 3
  4. 4. Please state in about 100 words, why you wish to join FIIBs PGDM Programme?Do you require hostel accommodation? Yes NoDETAILS OF DEMAND DRAFT: DD No._____________________________BANK ________________________________________________________DATE __________________ Rs. ______________________I ______________________________________ hereby certify that the above informationsubmitted by me is correct and that I have not provided any false or concealed any information.I understand that my admission may be cancelled and amount paid by me forfeited, incase anyof the above information given by me at the time of admission is subsequently found to bewrong, concealed or false. I agree to abide by the rules and regulations of the Institute. ADMISSION FORM____________________________ ___________________________ Signature of Parent/ Guardian Signature of the ApplicantDate: _________________________Place: __________________________ Enclosures: Attested photocopies of the following documents are required to be submitted along with the application form. Please specify below in checkbox (Do not attach original documents): I. Draft for Rs.1050/- favouring Fortune Institute of International Business payable at New Delhi, towards the registration fees ii. Date of Birth Certificate (Class X) iii.Graduation mark sheet (latest year if final year is not available) iv. MAT / CAT / Other Scorecard (Incomplete and illegible applications are liable to be rejected.) 4