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Plot No.5, Rao Tula Ram Marg, Vasant Vihar, New Delhi-110057
Tel: +91-11-47285000/48/41/11, , Fax: 011-26144279, Email: admissions@fiib.edu.in Website: www.fiib.edu.in


                                                                                  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 FORM
2. Date of Birth              DD               MM               YY
3. Current Address




City                                                      PIN Code

State

Applicant’s Mobile

E-mail




                                                                                 www.FIIB.edu.in/admissions
                                                                                                              1
4. Permanent Address




City                                                      PIN Code

State

5. Father’s Name


Father’s Profession

6. Mother’s Name


Mother’s Profession
Father’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 Bachelor's
 3.    Degree* (Specify)

       Post Graduate**
 4.
       (Specify)

       Any Other
 5.    (Specify)


* Select relevant one for Bachelor's 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.

                                                                                     www.FIIB.edu.in/admissions
C.     CORPORATE EXPOSURE
Work 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 & HONOURS

Academic/ Professional Awards/ Medals/ Prizes/ Scholarship/ Certificate/ Honours, etc.
                                                           Level (State / National/       Remarks
  Year       Name of Award       Awarding Institution
                                                           International )




                                                                                                           ADMISSION FORM
  E.     MISCELLANEOUS
Major Extra-Curricular Activities:
 Year      Activity               Role            Level                         Remarks




                                                                            www.FIIB.edu.in/admissions
                                                                                                           3
Please state in about 100 words, why you wish to join FIIB's PGDM Programme?




Do you require hostel accommodation?                 Yes           No

DETAILS OF DEMAND DRAFT: DD No._____________________________
BANK ________________________________________________________
DATE __________________ Rs. ______________________

I ______________________________________ hereby certify that the above information
submitted 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 any
of the above information given by me at the time of admission is subsequently found to be
wrong, concealed or false. I agree to abide by the rules and regulations of the Institute.




                                                                                                     ADMISSION FORM
____________________________                           ___________________________
  Signature of Parent/ Guardian                            Signature of the Applicant

Date: _________________________
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.)




                                                                        www.FIIB.edu.in/admissions
                                                                                                     4

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PGDM Admission Form_2012-14

  • 1. Plot No.5, Rao Tula Ram Marg, Vasant Vihar, New Delhi-110057 Tel: +91-11-47285000/48/41/11, , Fax: 011-26144279, Email: admissions@fiib.edu.in Website: www.fiib.edu.in 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 FORM 2. Date of Birth DD MM YY 3. Current Address City PIN Code State Applicant’s Mobile E-mail www.FIIB.edu.in/admissions 1
  • 2. 4. Permanent Address City PIN Code State 5. Father’s Name Father’s Profession 6. Mother’s Name Mother’s Profession Father’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 Bachelor's 3. Degree* (Specify) Post Graduate** 4. (Specify) Any Other 5. (Specify) * Select relevant one for Bachelor's 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. www.FIIB.edu.in/admissions
  • 3. C. CORPORATE EXPOSURE Work 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 & HONOURS Academic/ Professional Awards/ Medals/ Prizes/ Scholarship/ Certificate/ Honours, etc. Level (State / National/ Remarks Year Name of Award Awarding Institution International ) ADMISSION FORM E. MISCELLANEOUS Major Extra-Curricular Activities: Year Activity Role Level Remarks www.FIIB.edu.in/admissions 3
  • 4. Please state in about 100 words, why you wish to join FIIB's PGDM Programme? Do you require hostel accommodation? Yes No DETAILS OF DEMAND DRAFT: DD No._____________________________ BANK ________________________________________________________ DATE __________________ Rs. ______________________ I ______________________________________ hereby certify that the above information submitted 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 any of the above information given by me at the time of admission is subsequently found to be wrong, concealed or false. I agree to abide by the rules and regulations of the Institute. ADMISSION FORM ____________________________ ___________________________ Signature of Parent/ Guardian Signature of the Applicant Date: _________________________ 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.) www.FIIB.edu.in/admissions 4