Fortune Institute of International Business-Application Form For Admission to PGDM Programme

FORTUNE INSTITUTE OF INTERNATIONAL BUSINESS

Plot No.5, Opp. R.R. Army Hospital,
Rao Tula Ram Marg, Vasant Vihar, New Delhi-110057
Tel: 011-47285000, Fax: 011-26144279
Email: admissions@fortune.edu..in
Website: www.fortune.edu.in

Application Form

Two-year Full Time PGDM (2010-12) ProgrammeThree-year Part Time PGDM (2009-12) Programme

Entrance Exam Details
Cat Registration No*
Score*

A. Personal Data
Full Name Mr./Ms*
Date of Birth (dd/mm/yyyy)*

Mailing Address*
City*
State*
Pincode*
Mobile No*
Email*

Permanent address*
City*
State*
Pincode*
Land line*

B. Academic Qualifications

S.No.	Degree/Certificate	Board/University	Subjects	Year of Passing	Division/ Marks / Grade
1	10+2
2	10+2+3 (Bachelor's Degree* Specify )
3	Post Graduate** (specify)
4	Any Other ( Specify )
* Select relevant one for Bachelor's Degree -- B.A., B.Com., B. Pharma, B.E., B.Tech. ** Select relevant one for Post Graduate Degree -- M.A., M.Sc., M.Com., M.E. etc. Note: Overall percentage of marks should include all Subjects. If you are awarded grade points please convert them into percentage of marks and indicate. If there is a formula given by University for conversion it may please be declared. If you are a rank holder, indicate the same with class awarded. * If not yet complete, please give the detail of the present status and percentage in graduation obtained till now.

C. CORPORATE EXPOSURE

Work Experience(if any):

Name and address of Organization	Designation	Period From To	Nature of work	Last Salary Drawn(Anual)




Total Experience(if any)

D. AWARDS & HONOURS

Academic/ Professional Awards/ Medals/ Prizes/ Scholarship/ Certificate/ Honours, etc.

Year	Name of Award	Award Institution	Level(State Level/ National/ International)	Remarks

E. MISCELLANEOUS

Major Extra-Curricular Activities:

Year	Activity	Role	Level	Remarks

Please state in about 100 words, why you wish to join Fortune's PGDM Programme?

Do you require hostel accommodation?

YesNo

Details of Demand Draft:

DETAILS OF DEMAND DRAFT:DD no
Bank
Date
Rs

I hereby certify that the above information submitted by me is correct and that I have not provided any false/concealed information. I understand that my admission may be cancelled and amount paid by me forfeited, incase any of the above information given by me at the time of admission is subsequently found to be wrong, concealed or false. I agree to abide by the rules and regulations of the Institute.