Name of the Counsellor:-

IIBM Institute of Business Management

M.O.: ICR India 21, Paharpur Business Center, Nehru Place, New Delhi-19 Campus 1 : IIBM Tower, 1 Beripura, Near Era Mall, Delhi Road, Meerut 250002 (NCR)

Campus 2 : IIBM Tower, B 319, Pocket-B, Sec-1, Near Presidency School Shatabdi Nagar, Meerut 250002 (NCR) Tel : 011-32310200,32314235, 9219514364, 9219514358

Application for Admission

Please fill up the form in CAPITAL LETTERS only and Tick Wherever necessary 1. Name of the Candidate : 2. Gender : Male/Female : 3. Date of Birth : 4. Father's/Husband's Name : 5. Address for Communication :

Recent Passport Size Photograph

State: 6. Phone No. : (With Code) 7. E-mail ID : 8. Academic Qualifications : 9. Whether employed or not :

Pin Code: Mobile No.:

10. If Yes, specify the name and place of the Organization :

11. Examination Method Preferred : 12. Courses Selected 1.

2.

Postal Based

Email Based

Centre Based

3.

P.T.O

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IIBM

Electives Selected: (1) (2) 13. Opted for Fast Track Yes No

14. Payment Mode

Lumpsum Payment Scheme

Installment Scheme

15. Course Fees IInd Installment III

rd

I Installment Fee along with Application Form: : : :

Installment

Services Tax (12.36%) DD No & Date

: :
4 passport size photograph CV Demand Draft

Name of Issuing Bank

Checklist: Application form properly filled and signed. Graduation / 3rd yr Mark Sheet / Diploma Certificate Experience Certificate from the current employer

DECLARATION I have read and understood the rules and regulations of IIBM Institute of Business Management given in the prospectus and I do hereby agree to abide by the same. Place: Date: Signature of the Applicant

Rules and Regulation of the Institute

1. The Director of the Institute reserves the right to accept or reject an application without assigning any reason whatsoever. 2. The necessary fee to be paid by DD would be drawn in favour of IIBM Institute of Business Management Payable at New Delhi/Meerut will have to be sent along with the filled up application form. 3. No refund or adjustment of fee paid other than mentioned in the prospectus shall be made under any circumstance. In case of the rejection of an application, full paid fee will be refunded. 4. Allotment of examination centre in a particular place will be at the discretion of the Board of Examinations of the Institute which reserves the right to cancel any centre if there is insufficient number of students. 5. The Management of IIBM reserves the right to change the course details without notice as per the prevailing conditions. 6. All disputes subject to Jurisdiction of Court in Meerut City Only. 7. IIBM courses are industry endorsed certificate courses and are not recognized by UGC & AICTE. 8. Service Tax 12.36% is applicable.

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IIBM

Approval, Accreditation, Membership

Issued : 18-04-2012