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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
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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
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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
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