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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.
6. Application Fee Details;
Drawee Bank Branch Location DD/BC No. DD/ BC Date Amount (Rs.) (I) PERSONAL DAT A
Name of the Candidate
(As given in the certificates) D D M Date of Birth
Y Y Y Y Age as o n July 31, 2014
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)
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.
- Spring '14