5. REGISTRATION FORM
INDIAN INSTITUTE OF CAPITAL MARKETS
Professional Development programme on
“Finance for Non-Finance Executives”
We nominate the following participant to attend the Program:
Name of the participant: ______________________________________________________________
Designation : _______________________________________________________________________
Organisation : _______________________________________________________________________
Address: ____________________________________________________________________________
____________________________________________________________ Pincode:________________
Telephone:______________________________________ Fax No:____________________________
Mobile No.: __________________________ Email: ________________________________________
Cheque/DD. No_____________ dated _______________ for R _________________ drawn on
___________________________ in favour of “Indian Institute of Capital Markets” is enclosed.
Signature & Stamp of the Nominating Authority: ________________________________________
Programme Fees: R 20,000/-* (all inclusive) per participant on Non-residential basis
*Fees include participation’s course material, books (if any), lunch and tea/coffee.
Programme Dates: (Tick the appropriate Box) 
SN Dates Tick SN Dates Tick
1 August 27 – 31, 2012 4 February 11 – 15, 2013
2 October 29 – November 2, 5 April 15 – 19, 2013
2012
3 December 10 – 14, 2012
Registration form alongwith Cheque /DD to be send at the following address:
Indian Institute of Capital Markets
(UTI Institute of Capital Markets)
2 nd Floor Hindavi Bhavan, Plot No. 13, Sector 1
Vashi, Navi Mumbai – 400 703
Tel No.: 022-2782 0114/15 Telefax: 022-2782 0153/54
Email: pdp@utiicm.com, info@utiicm.com
Website: www.utiicm.com