School of Business Management

Shri Vile Parle Kelavani Mandal's

Narsee Monjee Institute of Management Studies

(Declared as Deemed-to-be University under Section 3 of the UGC Act, 1956)

School of Business Management

Post Graduate Diploma in Management (Executive)

Please read the eligibility criteria before applying for the Program

Personal Details:

First Name* :
_{(Own Name)}

Middle Name* :
_{(Father's / Husband's Name)}

Last Name :
_(Surname)

Gender* :

Birth Date* :
_(DD.MM.YYYY)

Marital Status* :

Age* :

Nationality* :

Place of Birth :

Social category* :

Blood Group :

Domicile* :

Domicile if Others :

Identity Proof* :

Are you a differently abled candidate? * :

Father's Name* :

Mother's Name* :

Address for Correspondence :

Address Line 1* :

Address Line 2 :

City* :

Pin Code* :

Telephone No. :

Mobile No.* :

E-Mail Address* :

Alternate E-Mail :

Permanent Address:

Address Line 1* :

Address Line 2 :

City* :

State* :

Country* :

Pin Code* :

Education Details *

Mode of completion of Bachelor's Degree * :

ONLY FULL TIME DEGREE

Exam	Name of the Institute	Degree Name	Board / University	Month & Year of passing	Marks obtained	Marks Out of	%/CGPA
10th*
12th*
Degree*
PG
Other courses (if any):

Current Job Profile:

Experience Details

SI. No	Name of the Organization	Address of the Organization	Designation	No. of Months
1
2
3
4
5

Awards : Please list here awards and distinctions such as medals, certificates, prizes, scholarships (Entries should be supported by documents)

Total No. of Months of Work Experience * (as on date) :

Current Remuneration(per annum) in Rs. :

How did you get to know about the Program?* :

Statement of Purpose:

Please write why do you want to join the program?

Document Upload

Std. 10 Documents* :

Std. 12 Documents* :

Graduation Marksheets (All semesters)* :

Graduation Degree Certificate* :

Work Experience Letter/s* :

Identification Card* :

Signature : (Optional)
_{Recommended upload size: 200px X 58px}

DECLARATION

I have checked all the entries in this application and they are true. I have kept all enclosures ready to be presented on demand, if admitted. I agree to comply with the rules of the University.

Date :

Place :

Signature of applicant

Application Processing Fee: INR 1250/- Only

You can pay application processing fee through electronic banking (NEFT/RTGS).

BANK DETAILS FOR APPLICATION FEE.
Name of A/c Holder :	SVKM - NMIMS
NEFT IFSC code:	KKBK0000661
Bank Name & Address	KOTAK BANK - JVPD, VILE PARLE (WEST), MUMBAI 400049
Beneficiary Account No.:	NM1YR+Mobile No+0
e.g. If your Phone No. is 8011812345, the Beneficiary account No. to be mentioned while doing RTGS will be as "NM1YR80118123450".
Please note that do not leave any space in between. In the space for Remarks please write your name and course name.
Type of Account:	Current
MICR Code:	400485022
NOTE : AFTER RTGS PAYMENT KINDLY SUBMIT BANK ACKNOWLEDGEMENT COPY TO ACCOUNTS COUNTER OR EMAIL TO citifeecounter@nmims.edu
FEE RECEIPT WILL BE MAILED TO REGISTERED EMAIL ID OF STUDENT AFTER 5 WORKING DAYS.

Payment Receipt Upload* :

Payment Reference No* :