The document appears to be an application form for admission to programs at the National Institute of Planning Management. It requests basic applicant information like name, date of birth, contact details, education history, work experience, and payment details. It lists eligibility requirements and fees for various MBA, diploma, and degree programs being offered. It also provides instructions for submitting the application and required documents. The applicant must sign a declaration agreeing to the institution's rules and certifying that the application information is accurate.

1. affix passport size
photo here
Form No.
Name
Date of Birth
Course applied for
Mailing Address
Particular Details
Gender
Nationality Maritual Status
Communication Details
Street/Vill
Locality
City
State Pin Code
E-mail Mobile No.
Permanent Address Put a tick if same as mailing address
Street/Vill
Locality
City
State
E-mail
Pin Code
Mobile No.
Education Details
P.T.O
First Qualification From in the Year
Application Form

2. Highest Qualification From in the year
Work Experience (Minimum 3 Years Work Experience mandatory for admission to executive MBA.)
Present Organization Designation
1.
Working from
2.
Previous Organization
Designation
Working from
3.
Previous Organization
Designation
Working from
Payment Details(INR)
Amount to Pay
Payment Method(put a tick and filled details)
in words
Demand Draft No.
Cheque
Online(Visit the Website)
(D.D Should be in favour of “National Institute of Planning Management” payable at Kolkata)
Bank Name
Branch Address
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Bank Name
Branch Address
(Cheque Should be in favour of “National Institute of Planning Management” payable at Kolkata)
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Enclosures
i)Attested Photocopies of the Certificates/Detailed Marks Cards of the Qualifying exams.
ii)Four stamp size photographs
iii)Demand Draft/Cheque
P.T.O
Form No. Page No.2

3. Form No. Page No.3
Important Instruction & Basic Rules
1.A Candidate seeking admission to any of the program should fill in the admission form in capital letters.
2.Candidate while sending the application form should submit the following documents.
a)Filled Application Form
b)Educational Documents such as Marks Cards & Certificate of 10th,12th,Degree & other professional Qualification.
c)The candidates should submit 4 copies of passport size photographs of which one should be pasted on the
application form.Remaining 3 copies should be duly signed with name & Date of birth.
3.Admission made to any program is provisional till the time the Institution/University finally approves it.
4.Candidates are required to preserve carefully the fee ceceipt and photocopy of DD/Cheque for all payments made to
nipm,as it is the only valid documents accepted.They may have to produce it at the time of obtaining the examination
admission ticket,marks sheet or any other documents.
5.Fee once paid will not be refunded under any circumstances.
Declaration by the Candidate
I Acknowledge to have fully read the application form,Rules & Regulations and certify that I have understood all the
provisions indicated therein.I certify that I am qualified for the programs as indicated in the Annextures-1.I hereby
certify that all the particulars stated by me in application are true to the best of my knowledge and belief.I understood
that my admissions is liable to be cancelled if I suppress or distort any information furnished in my application.I
understand that nipm/Institution/University reserves the right to modify/delete the syllabi,program structure,rules
and regulations,as and when required.I Understand fees once paid will not be refunded.I understand that the nipm/
Institution/University reserves the right to cancel the admissions without assigning any reason.
Place
Date
Signature of the Applicant
218,Banerjee Bagan,Hridaypur,Barasat,Kolkata-700127,E-mail:info@nipm.org.in
Provisional Receipt Copy
Name
Date of Birth
Course Applied for
Amount .in Rs.
Bank Name
DD/Cheque No.
IFS Code
Bank Address
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Client copy cut it from here

4. Page No.1
Annexure - 1
Program Lists
MBA
Executive MBA
PGDBA
PGD
Eligibility Duration Fee
Any Degree
Courses
Any Degree with 3 Year Work Experience
Any Degree
Any Degree
2 Years
2 Years
1 Years
1 Years
48,000
32,,000
5,000
5,000
Diploma in Business
Administration
Diploma in Marketing
Management
Diploma in Material
Management
Diploma in Finance
Management
Diploma in Supply Chain
Management
Diploma in Human
Resource Management
Diploma in Operation
Management
Diploma in Telecom
Management
10+2
10+2
10+2
10+2
10+2
10+2
10+2
10+2
1 Years
1 Years
1 Years
1 Years
1 Years
1 Years
1 Years
1 Years
4,000
4,000
4,000
4,000
4,000
4,000
4,000
4,000
MBA Specalizations:Human Resources,Banking & Finance,Energy,Infrastructure,IT& System,Project,Marketing,
Material,Logistic & Supply Chain,
EXECUTIVE MBA Specalizations:Human Resources,Banking & Finance,Energy,Infrastructure,IT& System,Project,
Marketing,Material,Logistic & Supply Chain,
Post Graduate Diploma Specalizations:Human Resources,Banking & Finance,Energy,Infrastructure,IT& System,
Project,Marketing,Material,Logistic & Supply Chain,
P.T.O

5. Page No.2
Annexure - 1
Program Lists
B.A
B.SC
BBA
BCA
Eligibility Duration Fee
10+2
Courses
10+2PCM
10+2
10+2
3 Years
3 Years
3 Years
3 Years
24000
24000
90000
90000
BLIS
BSW
MA
M.SC
MLIS
MSW
DIPLOMA
ENGINEERING
B.TECH
ANY DEGREE
10+2
10+2
10+2
1 Years
3 Years
2 Years
2 Years
1 Years
2 Years
3 Years
4 Years
12000
24000
18000
26000
12000
18000
90000
160000
P.T.O
ANY DEGREE
ANY DEGREE
BLIS
ANY DEGREE
END