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REGISTRATIONFORM
(Pleasereadinstructionscarefullybeforefillinguptheform)
FIRSTNAME
MIDDLENAME
LASTNAME
PARTIPERSONALDETAILS
NAMETOBEPRINTEDONCERTIFICATE
(WILLBEPRINTEDSAMEAS'FIRSTNAMEMIDDLENAMELASTNAME')
DATEOFBIRTH(DDMMMYYYY)
Recent
Passport size
Colour Photograph
MALE/FEMALE
ADDRESS
FLATNO/H.NAME&NO.
STREETNAME:
VILLAGE/AREA/DISTRICT:
LANDMARK:
STATE:________________________________________________________
CITY
(CandidatesSignatureSigninsidethebox)
PINCODE(Mandatory)
OFFICENUMBER(WITHSTDCODE)
EMAIL(MANDATORY)
BelowHigherSecondary
QUALIFICATIONDETAILS
RESIDENCE/MOBILENO:(WITHSTDCODE)
BELOWHIGHERSECONDARYONLY
Yes
HigherSec/TechnicalDiploma
Graduate
PostGraduate
No
HIGHERSECONDARY/TECHNICALDIPLOMA
MAJORSUBJECT
YROFPASSING
UNIVERSITY/INSTITUTE
%/GRADE
UNIVERSITY/INSTITUTE
%/GRADE
UNIVERSITY/INSTITUTE
%/GRADE
GRADUATIONDETAILS
MAJORSUBJECT
YROFPASSING
POSTGRADUATIONDETAILS
MAJORSUBJECT
YROFPASSING
OCCUPATIONALDETAILS
OCCUPATION
Student
SelfEmployed
Service
Others____________________(plsspecify)
IFEMPLOYED,KINDLYPROVIDECURRENTEMPLOYMENTDETAILS:
NAMEOFTHEORGANISATION
FROMDATE(DDMMMYYYY)
DESIGNATION
ADDRESSOFTHEORGANISATION
CITY
FAXNO.(WITHSTDCODE)
PINCODE
TELEPHONENO.(WITHSTDCODE)
NATIONALSTOCKEXCHANGE'SCERTIFICATIONINFINANCIALMARKETS(NCFM)
(Pleasereadinstructionscarefullybeforefillinguptheform)
Page2
PARTIITESTDETAILS
NCFM
(specifyregistrationnumber,ifalreadyregisteredunderNCFM.)
MODULENAME(TickthedesiredModule)
FinancialMarkets:ABeginners'Module
English
CorporateGovernanceModule
Gujarati
Hindi
MutualFunds:ABeginners'Module
ComplianceOfficers(Brokers)Module
ComplianceOfficers(Corporates)Module
CurrencyDerivatives:ABeginner'sModule
InformationSecurityAuditorsModule(PartI)
EquityDerivatives:ABeginner'sModule
InformationSecurityAuditorsModule(PartII)
HandDel/Courier
InterestRateDerivatives:ABeginner'sModule
CommoditiesMarketModule
MailsoftheDay
SecuritiesMarket(Basic)Module
NSDLDepositoryOperationsModule
Chkd/Reg./Scanned
OptionsTradingStrategiesModule
Enrollment/DDEntry
InvestmentAnalysisandPortfolioManagementModule
SMIssued/SMSent
CapitalMarket(Dealers)Module
English
Gujarati
Hindi
DerivativesMarket(Dealers)Module
English
ForOfficeUseonly
CommercialBankinginIndia:ABeginner'sModule
Gujarati
Hindi
FinancialModelingModule
FIMMDANSEDebtMarket(Basic)Module
SurveillanceinStockExchangesModule
Note: TestinCapitalMarket(Dealers)Module,DerivativesMarket(Dealers)Module,FinancialMarkets:ABeginners'Module
areavailableinEnglish,GujaratiandHindilanguages.Pleaseticktheappropriatelanguage.
PREFERREDTESTCENTRE
(mandatory)
TEST SCHEDULE
TESTSCHEDULE
TESTCENTRE
TESTDATE
D D
M M M
Y
Oncethetestdetailshasbeenspecifiedbythecandidate,thetestcannotberescheduled
Feesoncepaidshallnotberefunded.Testfeesarevalidfor180daysfromthedateofpayment.
Candidatesneedtoenrollforthetest(s)within180daysfrompaymentoffees.
TESTTIME
:
Y
H H
M M
PARTIIIPAYMENTDETAILS
DDNUMBER1
DDNUMBER2
DDNUMBER3
DDDATE(DDMMYY)
TOTALDDAMOUNT
ISSUINGBANK(NAMEANDBRANCH)
Icertifythattheaboveinformationprovidedbymeistrueandcorrecttothebestofmyknowledge,informationandbelief.
PLACE
DATE
0
(CANDIDATE'SSIGNATURE)
INSTRUCTIONSFORFILLINGUPREGISTRATIONFORM
1
Please fill in all details in the entire form only in BLOCK LETTERS. Write only one alphabet in each square provided. Leave one square blank between
words. Please fill in the First Name, Middle Name, Last Name and Date of Birth mandatorily. Fill in your DATE OF BIRTH in the following format : DD
MMMYYYY(e.g.23MAR1974)
2
3
NametobePrintedonCertificatewillbeprintedsameas'FirstNameMiddleNameLastName'.
4
5
Pleasementionfullcontactdetailswithcity,pincode&state.Pleasespecifyyourtelephoneno./mobileno.andemail.
Pleasefillinthequalificationandoccupationdetailsasmaybeapplicable.
Fees to be paid by Demand Draft in favour of 'National Stock Exchange of India Limited, payable at the nearest NSE office. Also keep a photocopy of the
demanddraftwithyou,beforeyousendittoNSE.Pleasewritethenameofthecandidateonthereverseofthedemanddraft.
Fees:(seeModuletablegiveninnextsheet)Pleasenotethattestfeesoncepaidarenonrefundable.
Scorecard: Scorecard is issued on the spot to the candidate after the completion of test (only if photograph is uploaded). This service is free of charge. For
subsequentrequestsforscorecardademanddraftofRs.50/ispayable.
You are required to paste a recent colour passport size photograph in the space provided. Do not staple the photograph. Do not sign across the
photograph.Signintheblockprovidedforsignature.
9 Onlineregistrationisalsopossibleonwww.nseindia.com.Pleasevisitthewebsiteforcompletedetails.
10 Pleaseticktheboxofthemoduleyouwishtoappear.ThedetailsofNCFMmodulesaregiveninthenextsheet
Feesoncepaidshallnotberefunded.Testfeesarevalidfor180daysfromthedateofpayment.Candidatesneedtoenrollforthetest(s)within180
daysfrompaymentoffees.
Atthetimeofthetest,ifitisseenthatthephotographhasnotbeenuploaded,thenyouwouldbeallowedtotakethetestonlyonfurnishingapassport
12 sizephotographandanattestedcopyofaphotoidproof(attestationbyGazettedOfficer).Theoriginalphotoidproofwouldberequiredtobeshownat
thetimeoftheexamination.
11
In the space provided for TEST DETAILS (PartII), Please mention Test Center. Test date and time may be submitted as per your choice and as per the
13 availability at each test center. Test date can be informed by email or fax. Please refer the format given on the website under offline registration
procedure.Thelistofthecandidateswhohavebeenenrolledwillbedisplayedonthesite.
The study material of all modules (except for Corporate Governance & Compliance Officers Modules) will be sent to you by courier in SEVEN working days
14 from date of payment. Please mark your envelopes as 'To NCFM Department'. Please note that study material will NOT be provided in case of balance
paymentbeingmade.
Forms can be sent by courier / post to any of the NSEIL offices. Form submission by hand delivery at all NSEIL offices is on MonFri between 10:00 am to
15 5:00 pm only. (In case of Ahmedabad it is between 10:00 am to 4:00 pm). In case of Mumbai office, the duly filled up form with requisite payment can also
beputinadropboxkeptatthemainentranceattheBandraKurlaoffice.
NCDEX distributes the training material of Commodities Market Module free of cost only to their active members and to others at a cost of Rs. 500/ plus
16 courier charges. Kindly contact NCDEX, Akruti Corporate Park, 1st Floor, Near G. E. Garden, LBS Marg, Kanjurmarg (West), Mumbai 400078 office for this
trainingmaterial.TelNo:02266406789
Study Material for the Corporate Governance module is available for sale at ICSI offices at: A) ICSICentre for Corporate Research & Training, Plot No.
101, Sector 15, Institutional Area, CBD Belapur, Navi Mumbai400614 #02227577814 16 Extn. 406, email: ccrt@icsi.edu, ccrt@vsnl.com B) Western
17
Indian Regional Council (WIRC) of the ICSI, 13 Jolly Makers Chambers II, First Floor, Nariman Point, Mumbai 400021, Tel No: 02222047569, Contact
Person:Mr.Mani,email:wiro@icsi.edu
IncaseofComplianceOfficersModules,candidatesarerequiredtorefertotherelevantbooks,circulars,manualsetc.,asperthegivencurriculum,on
18
theirown.NostudymaterialwillbeprovidedfortheComplianceOfficersModules.
19
Please note that the NCFM tests are conducted at NSEIL's offices from Monday to Friday only (at Mumbaion Sat also). Also once enrolled, tests cannot be
rescheduled/postponed.Thedetailsoftestcentresandtimingsaregivenbelow:
NameofTestCentre
TimeSlots(inhours)
NationalStockExchangeofIndiaLtd.,NCFMTestCentreMumbaiUnitedIndiaBuilding,2nd
Floor,NearKashmirEmporium,Opp.ApnaBazaar,SirPhirozeshahMehtaRoad,Fort,Mumbai 9:30to11:30
400001(LandmarkAboveIndianBank).Email:ncfm@nse.co.in
11:30to
13:30
13:30to15:30 15:30to17:30
NationalStockExchangeofIndiaLtd.,4thFloor,JeevanViharBuilding,ParliamentStreet,New
Delhi110001(LandmarkNearPatelChowk,MetroStation).Tel.:(011)2334431327Fax: 9:45to11:45
(011)23366658email:ncfm_delhi@nse.co.in
11:45to
13:45
13:45to15:45 15:45to17:45
NationalStockExchangeofIndiaLtd.,1stFloor,ParkViewApartments,
99,RashBehariAvenue,Kolkata700029(LandmarkDeshpriyaPark,NearPriyaCinema,
AboveGKBOpticals).Tel.(033)24631802/40400400Fax.(033)40400440;email:
ncfm_kolkata@nse.co.in
9:40to11:40
11:40to
13:40
13:40to15:40 15:40to17:40
NationalStockExchangeofIndiaLtd.,2ndFloor,IspahaniCentre,DoorNo.123124,
NungambakkamHighRoad,Nungambakkam,Chennai6000034(LandmarkNexttoIncome
9:35to11:35
TaxOffice/CAInstitute).Tel.:(044)28332500/01;28332511;Fax:(044)28332521;email:
ncfm_chennai@nse.co.in
11:35to
13:35
13:35to15:35 15:35to17:35
NationalStockExchangeofIndiaLtd.,HNo.36322,MahavirHouse,IIndFloor,Chamber
no.203&204,Basheerbagh,Hyderabad500029(LandmarkNearPoliceCommissioner's
Office,BasheerbaghSquare).Tel:(040)23227084/5Fax:(040)23227086.email:
ncfm_hyderabad@nse.co.in
11:30to
13:30
13:30to15:30 15:30to17:30
6
7
9:30to11:30
NationalStockExchangeofIndiaLtd.,406,SakarII,NearEllisBridge,Ahmedabad380006
11:30to
(LandmarkOpp.TownHall,NearEllisbridge).Tel.:(079)26580212/3Fax:(079)26576123.e 9:30to11:30
13:30
mail:ncfm_ahmedabad@nse.co.in
Anyothercentre(dependingondemand)visitourwebsite:nseindia.com>ncfm>testing>testatotherlocations
13:30to15:30 15:30to17:30
LISTOFMODULES
Sr.No. NAMEOFMODULE
Certificate
Duration No.
of
Pass Marks
MaxMarks
Validity (in Fees(Rs.)
(inmins)
Questions
(%)
yrs)
120
60
100
50
5
1500
120
60
100
50
5
1500
120
60
100
50
5
1500
120
60
100
50
5
1500
120
60
100
50
5
1500
1
2
3
4
5
FinancialMarkets:ABeginners'Module*
MutualFunds:ABeginners'Module
CurrencyDerivatives:ABeginner'sModule
EquityDerivatives:ABeginner'sModule
InterestRateDerivatives:ABeginner'sModule
CommercialBankinginIndia:ABeginner'sModule
120
60
100
50
1500
7
8
9
10
SecuritiesMarket(Basic)Module
CapitalMarket(Dealers)Module*
DerivativesMarket(Dealers)Module**
FIMMDANSEDebtMarket(Basic)Module
105
105
120
120
60
60
60
60
100
100
100
100
60
50
60
60
5
5
3
5
1500
1500
1500
1500
11
InvestmentAnalysisandPortfolioManagementModule
120
60
100
60
1500
12
13
14
15
16
17
NSDLDepositoryOperationsModule
CommoditiesMarketModule
SurveillanceinStockExchangesModule
CorporateGovernanceModule
ComplianceOfficers(Brokers)Module
ComplianceOfficers(Corporates)Module
InformationSecurityAuditorsModule(PartI)
InformationSecurityAuditorsModule(PartII)
OptionsTradingStrategiesModule
75
120
120
90
120
120
120
120
120
60
60
50
100
60
60
90
90
60
100
100
100
100
100
100
100
100
100
60#
50
60
60
60
60
60
60
60
5
3
5
5
5
5
120
75
140
60
NA
240
120
120
120
150
30
65
80
50
50
100
100
100
100
75
50
55
55
55
50
NA
2
2
2
NA
1500
1800
1500
1500
1500
1500
2250
2250
1500
2000per
exam
5000
1500
1500
1500
1000
18
19
20
21
22
23
24
25
FPSBIndiaExam1to4***
Examination5/AdvancedFinancialPlanning***
EquityResearchModule##
IssueManagementModule##
MarketRiskModule##
FinancialModelingModule###
2
5
*CandidateshavetheoptiontotakethetestinEnglish,GujaratiandHindilanguages.TheFMBM&CMDMworkbookisavailableinENGLISHONLY.
**CandidateshavetheoptiontotakethetestinEnglish,GujaratiandHindilanguages.TheDMDMworkbookisavailableinallthreelanguages.
***FollowingarethemodulesofFinancialPlanningStandardsBoardIndia(CertifiedFinancialPlannerCertification):
FPSBIndiaExam1to4i.e.(i)RiskAnalysis&InsurancePlanning(ii)RetirementPlanning&EmployeeBenefits(iii)InvestmentPlanningand(iv)Tax
Planning&EstatePlanning
Examination5/AdvancedFinancialPlanning
#Candidatessecuring80%ormoremarksinNSDLDepositoryOperationsModuleONLYwillbecertifiedasTrainers.
##ModulesofFinitiativesLearningIndiaPvt.Ltd.(FLIP)
###ModuleofIMSProschool