The document is an application form for a post-graduate banking and finance program at the National Institute of Bank Management, which requests personal details, education history, work experience, extracurricular activities, and a declaration from applicants. Instructions are provided on the back of the form regarding correctly filling out and submitting the application along with supporting documents and payment.

1. NATIONAL INSTITUTE OF BANK MANAGEMENT
APPLICATION FORM
POST-GRADUATE PROGRAMME IN BANKING AND FINANCE
(Session Beginning 2013)
Please read the instructions (given on the back of this form) carefully before filling-up this application form.
Affix
Photograph of
4 cms x 3.5 cms
A. Personal Information
First Name (Mr/Ms.)
Middle Name
Last Name
Date of Birth 1 9
DD MM YY
Please tick mark ( ) Female Male Married Single
Mailing Address
House No./Area/
Locality/Street/
City
State
Pin Code
STD Code & Tel. No.
E-mail ID
B. CAT Registration No.
As it appears in your CAT voucher
C. UTR/Demand Draft Details
Name of the Bank UTR/DD No. Date
D. Preferred PGPBF Interview Centres, viz. Pune/Mumbai/Delhi/Kolkata/Chennai
(Centres other than Pune are tentative)
First Preference
Second Preference
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2. E. Academic Qualifications
Qualification Name of the Name of the Year of Marks (%) or Degree with
Institution/ Board/ Completion* CGPA Stream
Professional Body University (max/obtained)
State/UT
Secondary
School (X)
Sr. Secondary
School (XII)
Graduate
Degree
Post-Graduate
Degree
Professional
Degrees/
Diploma/ 1.
Certificate
2.
* (Please mention Final Year of Completion only. Otherwise write appearing.)
F. Work Experience [Furnish details of a maximum of five full-time jobs starting with latest/current job first]
Designation of Period Emoluments
Organization Designation Nature of Experience Size/Turnover
Last Person from/to Per Annum
Name Duties in Years of Organization
Reporting to dd/mm/yy Rs.
Total Experience [ in years ]
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3. G. Academic/Professional Awards/Medals/Prizes/Scholarships/Certificates/Honours, etc
(Excluding those for extra-curricular activities)
Name of the Award Awarding Institution Level Basis of Award Year
H. Major Extra-Curricular Activities/Hobbies
Year
Activity Role Level Honours if any Remarks
From To
I. Declaration
All entries made in this application form are true to the best of my knowledge and belief. I am willing to
produce original certificates in support thereof if asked to do so at any stage.
Place ______________________________
Date _______________________________
Signature
(Please see overleaf for Instructions for Filling the Application Form)
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4. Instructions for Filling the Application Form
(a) Fill in the application form in CAPITAL letters with pen. Complete all items relevant to you. Incomplete
applications will be rejected. Any mistakes and/or loss on account of wrong and/or illegible entries are
the sole responsibility of the applicant.
(b) Mention your name (as it appears in the CAT Voucher) and CAT Registration number in the NIBM
Application Form.
(c) Columns A, B, C, D, E & I are compulsory fields and should be filled-up.
(d) Columns G and H are optional fields. However, these may become important at some stage of your
selection/studies.
(e) Please paste your photograph in the appropriate space provided, do not staple it.
(f) Please make sure that you attach a photo copy of the CAT admit card with this application form.
(g) Candidates appearing for the final year bachelor’s degree/equivalent qualification examination and those
who have completed degree requirement and are awaiting results must attach photocopy of the certificate
from the Principal/Head of the Department/Registrar/Director of the University/Institution certifying
that the candidate is currently in the final year/is awaiting final results and has obtained at least 50%
marks or equivalent based on the latest available grades/marks. If admitted, admission of such candidates
will be provisional and subject to their completion of all the eligibility requirements of the Programme
mentioned in the prospectus.
(h) While sending your application form to NIBM, enclose a self-addressed postcard, if you need
acknowledgement.
(i) Please do not enclose any testimonials along with the form. All certificates (original) should be produced
at the time of the interview.
(j) The filled-in application form should be accompanied with a payment of Rs 1250. The amount may
preferably be transferred by RTGS/NEFT/ECS to our A/c No. 20002400021 with Bank of Maharashtra,
NIBM branch, Pune (IFSC Code MAHB0001124). For all electronic remittances, kindly send a confirmatory
e-mail at: pgpbf@nibmindia.org giving details of the remitters name, the UTR No., etc. In case, the
amount is remitted by demand draft, it should be made in favour of 'National Institute of Bank
Management', drawn on any bank and payable at Pune. The remittence and the filled-in application form
should reach NIBM before December 5, 2012 (for CAT applicants). We will send a copy of the Prospectus
by post subsequently.
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