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Application Form PDF

This document appears to be an application form for a course at the Indian Institute of Business Management and Studies (IIBMS). The form collects personal details of the applicant such as name, date of birth, address, contact information, academic and work experience details. It also collects payment details and includes a declaration by the applicant agreeing to abide by the institute's rules and standards. The form checklist confirms submission of required documents such as qualification proofs, photographs, ID and address proofs, CV, payment receipt. Notes provide additional information regarding the application process such as acceptable payment methods and policies regarding fees.

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Amal
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33 views

Application Form PDF

This document appears to be an application form for a course at the Indian Institute of Business Management and Studies (IIBMS). The form collects personal details of the applicant such as name, date of birth, address, contact information, academic and work experience details. It also collects payment details and includes a declaration by the applicant agreeing to abide by the institute's rules and standards. The form checklist confirms submission of required documents such as qualification proofs, photographs, ID and address proofs, CV, payment receipt. Notes provide additional information regarding the application process such as acceptable payment methods and policies regarding fees.

Uploaded by

Amal
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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VALAM EDUCATION SOCIETY Maharashtra Govt. Regd.

IIBMS

Course Name: ________________________________________________

Specialization: ________________________________________________

Branch Name : ____________________ Branch Code : ______________

Counselor Name: ______________________________________________

APPLICANT DETAILS
Name:
(Surname) (First Name) (Middle Name)

D.O.B. Male Female


DD MM Y Y Y Y

Married: Unmarried: Nationality: _____________

Father’s/Husband’s Name:

Mother’s Name:

Correspondence Address:

Landmark : P I N :

S T A T E

Permanent Address:

Landmark : P I N :

S T A T E

Tel. No.: (M)

(R) with STD Code

(O)

E-mail:

Alternate E-mail:

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IIBMS

Academic Details:
Qualification Board/University Passing Year/Month Grade/Class Specilization if any

Work Experience: (Starting with recent experience)


From
Company Name City/State Designation Year/Month To Year/Month Remarks

Exam Option: From Home: Study Centre: E-mail:

Fee Paid : US $ / INR ` Cash / D.D. / Cheque / C.C. No.:

Bank:

Declaration by Applicant :
I declare that I have understood the course aspects and student section of Indian Institute of Business Management and Studies. I assure to abide by the
conditions and standards of the institute. I have followed the instructions for application & I am fully aware that if I am found violating any of the above mentioned
rules then I would be solely responsible for it.

Documents Checklist :
r Qualification Proof : Photocopy of Mark sheets and certificates for proof of all examination cleared.
r 3 Passport size Colour Photographs r ID Proof r Address Proof r CV r Cheque / DD r Experience Proof
Notes :
• The Application Form along with checklist documents should be sent to the Institute through Courier / Speed Post. • Cash Payment is accepted only at Head
Office & branches • Cheque/DD should be in Favor of "Indian Institute of Business Management & Studies" payable at Mumbai. • Cheques are
acknowledged subject to realisation. • Fees once paid is not refundable/transferable under any circumstances. • The receipt shall be valid only with mail
confirmation from [email protected] • Incase of non receipt of email confirmation please contact accounts department IIBMS Head Office Mumbai. •
Course and Fees are valid upto the maximum duration of course from the date of enrollment • Subject to Mumbai Jurisdiction Only.

Date: ______________ Signature: ________________

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