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IIBM Institute of Business Management

M.O.: IIBM 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 : (Admin Office) 0121-4054591/92/93/94 (Marketing Office) 011-32310200, 011-65151770

PLEASE FILL COMPLETE FORM IN BLOCK LETTERS

Counsellor Name
Student Category

INDIAN

Affix Photos
(Attach 4 Extra
Copies with this
form for ID card
& Office Use)

NRI/INTERNATIONAL

(Mr./Ms./Dr.)

(First Name)
(Middle Name)

ADMISSION FORM

(Last Name)
d

Date of Birth:

Gender:

MALE

FEMALE

Correspondence Address (Please mention the address where you would like to receive your Study Material)
Address:
City:
State:
Country
: Tel.:

Pin Code:
S

Do not begin with zeros

Mobile
Email:
Alternate E-mail:

Permanent Address (Please fill if different from Correspondence Address or write 'SAME AS ABOVE')
Address:

City:
State:
Country:
Tel.:

Pin Code:
S

Mobile

Do not begin with zeros

Your Current Organization Details


Name of the Organization
Total Service (Years)

Current Designation:

Academic Details (Highest Educational Qualification Only)


Examination

Board / University Year of Passing

Discipline

Class / Division

% Marks

Course Selected: (Please refer to the Information Brochure or ask your Counsellor)
Dual Certification Program:
Post Graduate Diploma in Management+ Master Program in Business Administration 2 Years

Management Certification Programs:


Master Program in Business Administration - 1 Year
Master Program in Business Administration - 1 Year + 3 Certifications
Master Program in Business Administration - 2 Year

ADMISSION FORM

Master Program in Business Administration - 2 Year + 3 Certifications


Executive Master Program in Business Administration - 1 Year
Executive Master Program in Business Administration - 1 Year + 4 Certifications
Certified Manager - 6 Months
Associate Certified Manager - 6 Months
Certified Manager + 3 Certifications - 6 Months
Associate Certified Manager + 3 Certifications- 6 Months

Diploma Programs:
Diploma in Business Administration - 6 Months
Advance Diploma in Business Administration - 6 Months
Integrated Certification Programs:
Diploma in Business Administration + Master Program in Business Administration - 1 Year
Diploma in Business Administration + Master Program in Business Administration - 1 Year + 3 Certifications
Diploma in Business Administration + Master Program in Business Administration - 2 Year
Diploma in Business Administration + Master Program in Business Administration - 2 Year + 3 Certifications
Diploma in Business Administration + Executive Master Program in Business Administration - 1 Year
Diploma in Business Administration + Executive Master Program in Business Administration - 1 Year + 4
Certifications
Post Graduate Certification Programs:
Post Graduate Diploma in Business Management - 2 Years
Executive Post Graduate Diploma in Business Management -1 Year

Specialization 1:
Specialization 2:
Opted For Fast Track:

Yes

Examination Method:

Postal Based

No
Email Based

Centre Based

Payment Method:

Lumpsum

Installment

Mode of Payment:

DD/Cheque

Online Transaction

Cash Deposit

Course Fee:
Particulars

Amount

DD/Cheque

Date

Bank

Lumpsum / Ist Installment


IInd Installment
IIInd Installment
Examination Fee
Service Tax

Self Attested photo copy of following Documents Attached herewith (Please Tick):
Graduation 3rd Year Marksheet / Diploma

4 Photographs

Experience Certificate

CV

ADMISSION FORM

Certificate of Undertaking
I have carefully read the rules and regulations as given in this Application and agree to abide by the same. I understand these rules are only indicative
and may be modified/changed/revised from time to time. I agree not to countermand and to honor all the post dated cheques enclosed by me
towards the Installment Facility. I understand that in case I withdraw from the program I will not be entitled to claim any refund of amount paid. I
agree that I will settle the amount with IIBM whether or not I continue in the program, I understand the Jurisdiction for all disputes (if any)
relating to the Institute is only/exclusively Meerut, Uttar Pradesh. I hereby declare that the information provided by me in the Application is true
and correct to the best of my knowledge. My signature below certifies that I have read understood and agree to the rules and regulations, including
Legal Aspects and my financial responsibilities.

Place: ..........................

Date: .........................

Signature of 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. 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.
4. The Management of IIBM reserves the right to change the course details without notice as per the prevailing conditions.
5. IIBM Institute of Business Management is NOT a university & hence none of our courses lead to degrees.
6. IIBM courses are industry endorsed certificate courses.
7. Service Tax of 12.36% is applicable on all the course of IIBM.

STC-Issue Date 27/02/2014

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