Isb Lim Form

Application Form Batch: LIM-01
Leadership Programme in
Infrastructure Management
2016
01
Personal Application
(to be filled up by all applicants)
Title: Ms
First Name*
Date of Birth*:
DD
Middle Name
MM
Current Address*:
YYYY
City*:
Last Name*
Country*:
State*:
Pin Code*:
Personal Email ID*:
Official Email ID*:

Mobile (Personal)*:
Alternate Telephone Number*:
Education
Degree
Course
University
Percentage/
CGPA
Year of Graduation
Under Graduation*
Post Graduation
Professional Information
Total Years of Work Experience:
Total Years of Work Experience in infrastructure Industry:
Employment History (last three employers only)
S.No.
Designation
Organisation
Function
Years of Experience
1
2
3
Your Current Salary
Below Rs. 5 lakhs
Rs. 5-10 lakhs
Rs. 11-15 lakhs
Rs. 16-20 lakhs
> Rs. 20 lakhs
02
Statement of Purpose
Essay 1: Please write your reason(s) for wanting to pursue LIM. In your response, please address: how your personal and/
or professional experiences have shaped your interest in studying infrastructure management. (300 words)
Essay 2: Please write about your career goals and ambitions, and how the LIM will help you achieve these; how will the
LIM help you in contributing to the infrastructure industry. (300 words)
Essay 3 (Optional): Tell us anything else you want us to know that you have not had the opportunity to describe
elsewhere in the application, which will support your candidature for the LIM. (200 words)
03
Company Application
(to be filled up by the nominating Executive/Manager/HR of the applicant

for company sponsored applicants. Not applicable for self-sponsored applicants)
Title: Ms
First Name*
Middle Name
Last Name*
Job Title*:
Relation with Applicant*
Reporting Manager
HR
Others (specify)
Company Name*:
Company Address*:
City*:
Country*:
State*:
Pin Code*:
Official Email ID*:
Office Land Phone*:
Mobile Phone*:
STD code
PAN/TAN*:
Please describe the nature of sponsorship to the applicant.
Full sponsorship of programme fee of Rs. 9 lakhs + taxes

Part sponsorship of programme fee of Rs.
lakhs + taxes
Paid time off for attending the programme

Any other (specify)
Please describe the development needs of the applicant which you hope will get addressed by this programme. (100 words)
Name:
Date:
DD
MM
YYYY
Invoicing Details
Please indicate by ticking on Yes if the address mentioned above is the same for invoicing.
Yes
No
If the address is not the same, please mention the detailed address of where the invoice needs to be sent.
Title: Ms
First Name*
Middle Name
Job Title*:
Last Name*
Company Name*:
Company Address*:
City*:
State*:
Country*:
Official Email ID*:
Pin Code*:
Office Land Phone*:
STD code
Mobile Phone*:
PAN/TAN*:
04
Reference
(to be filled by all applicants)
Please provide two references

Reference 1
Title: Ms
Name
Designation:
Company:
Address:
Email ID:
Land Phone number:
STD code
Mobile number:
Reference 2
Title: Ms
Name
Designation:
Company:
Address:
Email ID:
Land Phone number:
STD code
Mobile number:
05
Referral
Please refer any individual you feel may benefit from this programme.
S.No.
Name
Designation
Company
Email Id
Phone
1
2
3
06
Scholarship Form
(to be filled up by self-sponsored candidates)
1. A scholarship of Rs. 2 lakh is available for deserving self-sponsored candidates

2. Scholarship will be awarded on the basis of:
a. Applicants passion to work and contribute to the infrastructure industry
b. Performance in the personal interview
3. Award of scholarship will be indicated along with the admission offer letter
Essay 1: Describe the solutions you would propose to improve or resolve a current issue in infrastructure industry
in India. (300 words)
Essay 2: Discuss a special attribute or accomplishment in the recent past that sets you apart. (300 words)
07
Application Fee
The application fee of Rs. 1,000/- is non-refundable and has to be paid at the time of submitting the application.
The application fee can be paid by Online Transfer or Cheque/Demand Draft only.
Online Payment
Bank details for Online Transfer is as below
Name of Beneficiary: Indian School of Business
Bank Name:
Indian Bank
Branch Address:
Main Branch, Koti, Hyderabad-500 001
Bank A/c No:
710124779
IFSC/NEFT code:
IDIB000H013
MICR Code:
500019003
Cheques/Demand Draft Payment
Payments by Cheque/Demand Draft are to be drawn in favour of the Indian School of Business payable at Hyderabad.
Please mention applicant name and programme name on the reverse of the instrument for easy tracking. The instrument
has to be sent to the address below with a covering note.
Marketing Services, Centre for Executive Education
Indian School of Business, Gachibowli, Hyderabad - 500 032, India
Please Provide Application Fee Payment Details (to be filled by all applicants).
NEFT Bank Transfer

Payment ID:
NEFT UTR Number:
Internet Banking Ref. No.:
Cheque/Demand Draft
Name of the Bank:
Instrument Number:
Date of the Instrument:
Amount Rs.
08
Guidelines/Instructions/Terms and Conditions
1. Submission of Application
a. Duly filled up applications with scanned supporting documents have to be emailed to [email protected]
i. Self-sponsored candidates to use subject line Application for LIM - <Participant Name>
ii. Applications of company sponsored candidates have to be emailed by the nominating representative of the
organisation with the subject line - Nomination for LIM <Company Name>/<Participant Name>
b. On submission of the application, applicants will receive an acknowledgement email with a submission number.
This submission number must be quoted for all further correspondence regarding the applicants candidature
to the programme
c. Only shortlisted applicants will be notified for the interview round
2. Application Checklist
The following documents should be scanned and emailed along with the application:
Colour photograph
Undergraduate Degree or Diploma marksheets/transcripts (for all semesters/years)
Undergraduate Degree/Diploma Certificate
Marksheets/transcripts and certificates for additional education (if applicable)
Company Support Letter (not applicable for self-employed individuals/business owners)
Two Professional Recommendations from current/previous supervisors
Employer Support Letter (submitted either along with the application or along with the acceptance of admission offer.
Business Owners/Self Employed individuals are not required to submit this documents
3. Cancellation Policy
In case, a student has to withdraw from the programme for either academic, personal or administrative reasons, the
student will receive pro-rated refund for only the remaining terms to the extent that the student has paid for those
terms in advance. No refund will be granted for the terms which have already commenced or have been completed. The
programme office reserves the right to deduct additional amounts which have been paid in advance to vendors for boarding
and lodging, etc., which cannot be recovered by ISB even though the participant has not attended the terms for which
these expenses were incurred in advance.
09
Declaration
I have read all the Guidelines/Instructions/Terms and Conditions provided as part of the LIM Application. I hereby certify
that the information provided by me in this application is accurate and complete in all respects. I authorise all persons
or entities to provide any relevant information in their possession to the Indian School of Business in considering me for
admission or verifying my credentials for admission, and I expressly waive any required notice to me. I understand and
agree that any misrepresentation or omission of facts in my application will justify the denial of admission, the cancellation
of admission, or expulsion. This application is my honest statement to the Admission Committee. I also authorise the ISB
or its representative to carry out any kind of verification of academic or employment details given
in my application.
Name of the Applicant:
Date:
DD
MM
YYYY

Isb Lim Form

Uploaded by

Copyright:

Available Formats

Isb Lim Form

Uploaded by

Document Information

Original Description:

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Isb Lim Form

Uploaded by

Copyright:

Available Formats

Application Form Batch: LIM-01

(to be filled up by all applicants)

Personal Email ID*:

Official Email ID*:

Alternate Telephone Number*:

Rs. 5-10 lakhs

Rs. 11-15 lakhs

Rs. 16-20 lakhs

> Rs. 20 lakhs

(to be filled up by all applicants)

(to be filled up by the nominating Executive/Manager/HR of the applicant

Official Email ID*:

Office Land Phone*:

Full sponsorship of programme fee of Rs. 9 lakhs + taxes

Paid time off for attending the programme

Official Email ID*:

(to be filled by all applicants)

Please provide two references

(to be filled up by self-sponsored candidates)

1. A scholarship of Rs. 2 lakh is available for deserving self-sponsored candidates

NEFT Bank Transfer

Guidelines/Instructions/Terms and Conditions

(to be filled up by all applicants)

You might also like