Please submit your application so as to reach iim

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Unformatted text preview: Please submit your application so as to reach IIM Indore on or befo re April 4, 20 14 along with attested copies of academic marksheets/certificates. IIM Indore will not be responsible for any postal dela y. The application fee of Rs. 1000/- (for General and NC-OBC Category) or Rs. 500 /- (for SC, ST an d DA ) is payable by candidates in the form of a Demand Draft (DD)/Banker’s Cheque (BC) drawn in favour of “Indian Institute of Management Indore”, payable at Indore. Application Fee is non-refundable. 1. 2. 3. 4. 5. 6. Application Fee Details; Drawee Bank Branch Location DD/BC No. DD/ BC Date Amount (Rs.) (I) PERSONAL DAT A T Name of the Candidate (As given in the certificates) D D M Date of Birth M Y Y Y Y Age as o n July 31, 2014 Years Months Gender (Tick appropriate one) Male Female Affix your recent passport size colour photograph here Category (Tick appropriate one) General NC-OBC SC ST Please tick the relevant box if you belong to Differently Abled (DA)/Persons with Disabil ity (PWD) catego ry and your Physical Disability is to the extent of not less than 40% (as per the Person with Disabilities Act, 1995) Blindness/ Locomotors Disability/ Hearing Impairment Cerebral Palsy Low Vision Please mention the percentage of Disability (%) Note: (Candidates belonging to NC-OBC/SC/ ST/DA(PWD) need to submit valid cer tificate...
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This document was uploaded on 03/12/2014.

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