International Management Institute Kolkata
Fellowship Programme in Management (FPM) Online Application Form 2019 (AICTE Approved)
Programme Details
INSTRUCTIONS
Mention the Programme of your Choice
Personal Details
Upload Passport/ Stamp Size Photograph
Name *
Date of Birth *
MM
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Nationality *
Father's/Mother's/Spouse's Name *
His/Her Occupation and Annual Income in Rs.
Permanent Address *
Address for correspondence
Communication Email Id.
Contact Number *
Alternate Contact Number
Academic details
Class X
Name of the School and Place *
X/SSC Board *
Year of Passing
Grade Point/Percentage *
Required
Marks Obtained *
Academic Stream / Specialisation
Class XII
Name of the School and Place *
XII/HSC Board *
Year of Passing
Grade Point/Percentage *
Required
Marks Obtained *
Academic Stream / Specialisation
Graduation
Name of the College and Place *
University / Board
Year of Passing
Grade Point/Percentage *
Required
Marks Obtained *
Post-Graduation
Name of the University and Place
Year of Passing
Grade Point/Percentage
Marks Obtained
Academic Stream / Specialisation
M.Phil
Name of the University and Place
Year of Passing
Grade Point/Percentage
Marks Obtained
Academic Stream / Specialisation
Other Qualification (if any)
Name of the Exam
If "Other" please specify
Year of Passing
Entrance Exam Details
Exam Name
CAT
Overall Percentile
GMAT
Total Percentile
GRE
Overall Score
Give details of your past and present paid employment, if any:
Latest Job details
Name of Employer
Place of Employment
Nature of Work
Start Date
MM
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DD
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YYYY
End Date
MM
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DD
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YYYY
Reason for Leaving
Previous Job details (Optional)
Name of Employer
Place of Employment
Nature of Work
Start Date
MM
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DD
/
YYYY
End Date
MM
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DD
/
YYYY
Reason for Leaving
Name of Employer
Place of Employment
Nature of Work
Start Date
MM
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DD
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YYYY
End Date
MM
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DD
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YYYY
Reason for Leaving
Which field of study are you interested in?
Give reasons:
( A typed copy of Statement of Purpose [in about 1,000 to 2,000 words] on the proposed area of study in the following format should be attached)
Referee Details
Please mention the names and designations of two academic referees who can testify to your ability to pursue the FPM
First Referee Details
Name
Designation
Address
Town/City
State
Country
Postal Code
Email Address
Capacity in which known
Phone No.
Second Referee Details
Name
Designation
Address
Town/City
State
Country
Postal Code
Email Address
Capacity in which known
Phone No.
Required Documents
(Only Self attested copies need to be attached to the application. Candidates will be required to produce original certificates and testimonials of Degrees and Diplomas only at the time of interview)
Copy of a document giving proof of Date of Birth (e.g., Birth Certificate, School leaving Certificate, etc.)
Class X Marksheet
Class XII Marksheet
Certificate Copy of Bachelor's Degree
Copy of Bachelor's Degree Marks/ Grade
Certificate Copy of Master's Degree
Copy of Master's Degree Marks/ Grade
Copy of M.Phil Degree Certificate (if Applicable)
Copy of Work Experience Certificate
DECLARATION
I certify that the information given in this application is complete and accurate to the best of my knowledge and that I have not been disqualified by any University for any examination or for seeking admission for any course of study. If admitted, I agree to abide by the rules and regulations of the institute.
Date of Submission
MM
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Signature of Applicant
Payment Details
Application Fee
Submit
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