NATIONAL INSTITUTE OF BANK MANAGEMENT

APPLICATION FORM
POST-GRADUATE PROGRAMME IN BANKING AND FINANCE
(Session Beginning 2009)

No.
Please read the instructions (given on the back of this form) carefully before filling-up this application form.

Affix
Photograph of
4 cms x 3.5 cms

A. Personal Information

First Name (Mr/Ms.)

Middle Name

Last Name

Date of Birth 1 9
DD MM YY

Please tick mark () Female Male Married Single

Mailing Address

House No./Area/
Locality/Street/
City

State

Pin Code

STD Code & Tel. No.

E-mail ID

B. CAT Details (Write your CAT Application No. and Registration No. as it appears in your CAT Admit Card)

CAT Application No.

CAT Registration No.

CAT Centre Code

C. Preferred PGPBF Interview Centres, viz. Pune/Mumbai/Delhi/Kolkata/Chennai

(Centres other than Pune are tentative)
First Preference

Second Preference

1
D. Academic Qualifications

Qualification Name of the Name of the Year of Marks (%) or Degree with
Institution/ Board/ Completion* CGPA Stream
Professional Body University (max/obtained)
State/UT

Secondary
School (X)

Sr. Secondary
School (XII)

Graduate
Degree

Post-Graduate
Degree

Professional
Degrees/
Diploma/ 1.
Certificate
2.

* (Please mention Final Year of Completion only. Otherwise write appearing.)

E. Work Experience [Furnish details of a maximum of five full-time jobs starting with latest/current job first]

Designation of Period Emoluments

Organization Designation Nature of Experience Size/Turnover
Last Person from/to Per Annum
Name Duties in Years of Organization
Reporting to dd/mm/yy Rs.

Total Experience [ in years ]

2
F. Academic/Professional Awards/Medals/Prizes/Scholarships/Certificates/Honours, etc
(Excluding those for extra-curricular activities)

Name of the Award Awarding Institution Level Basis of Award Year

G. Major Extra-Curricular Activities/Hobbies

Year
Activity Role Level Honours if any Remarks
From To

H. Declaration
All entries made in this application form are true to the best of my knowledge and belief. I am willing to
produce original certificates in support thereof if asked to do so at any stage.

Place ______________________________

Date _______________________________

Signature

(Please see overleaf for Instructions for Filling the Application Form)
3
 Instructions for Filling the Application Form

(a) Fill in the application form in CAPITAL letters with pen. Complete all items relevant to you. Incomplete
applications will be rejected. Any mistakes and/or loss on account of wrong and/or illegible entries are
the sole responsibility of the applicant.

(b) Mention your name (as it appears in the CAT Application Form), CAT Application number, CAT
Registration number and CAT Centre Code in the NIBM Application Form.

(c) Columns A, B, C, D & H are compulsory fields and should be filled-up.

(d) Fill Column E if it is applicable.

(e) Columns F and G are optional fields. However, these may become important at some stage of your
studies.

(f) Please paste your photograph in the appropriate space provided, do not staple it.

(g) Make sure that you attach a photo copy of the CAT admit card with this application form.

(h) Candidates appearing for the final year bachelor’s degree/equivalent qualification examination and those
who have completed degree requirement and are awaiting results must attach photocopy of the certificate
from the Principal/Head of the Department/Registrar/Director of the University/Institution certifying
that the candidate is currently in the final year/is awaiting final results and has obtained at least 50%
marks or equivalent based on the latest available grades/marks. This certificate would have already
been obtained at the time of applying for CAT 2008, by such candidates. If admitted, admission of such
candidates will be provisional and subject to their completion of all the eligibility requirements of the
Programme mentioned in the prospectus.

(i) While sending your application form to NIBM, enclose a self-addressed postcard, if you need
acknowledgement.

(j) Please do not enclose any testimonials along with the form. All certificates (original) should be produced
at the time of the interview.

(k) Send your Application Form with the above details on or before the last date, i.e. December 04, 2008.

(l) If you have downloaded the application form from the website, the filled-in application form should be
accompanied with a Demand Draft (DD) of Rs 1000/- drawn in favour of ‘National Institute of Bank
Management’ payable at Pune. The DD along with the filled-in application form should reach NIBM on
or before December 04, 2008. On receipt of this, we will post a copy of the Prospectus, and process your
application form.

(m) Mail the completed application form after folding into two halves in the envelope provided with the
Prospectus. If you have downloaded this form kindly use the right size envelope to ensure this.

(n) Indicate your intention of applying to NIBM (non-IIM Institutes) while filling-up the CAT Application
Form as well as on the answer sheet of the CAT examination.

@@@@@@@@@@@@@@