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JAIPURIA INSTITUTE OF MANAGEMENT, INDORE

Dakachaya, Indore Dewas Highway,
Nr, Shipra Naka, Indore - 453771 M. P.
City Office , 407, Orbit Mall, A.B. Road, Indore 452008

Website: http://www.jimindore.ac.in

Instructions:

	This form is an integral part of the admission process to PGDM. Please provide correct information. Admission granted with incorrect information will be ipso facto null and void.
	Each applicant is required to answer essay questions, which are included in the online application form to demonstrate his/her potential as a prospective PGDM student.
	Candidates choosing the option for payment by Demand Draft, may draw a DD in favour of "Jaipuria Institute of Management, Indore", Payable at Indore of Rs. 1000/‐, should be sent to: Jaipuria Institute of Management, Indore, City Office, 407, Orbit Mall, AB Road, Indore ‐ 452008
	In all matters regarding admission to the PGDM, the decision of the institute will be final and binding on the applicant. No correspondence from the applicant with respect to his/her non-selection will be entertained.
	Should you find any problem with online payment , in the event that your Master/Visa Card is not registered , in that case we suggest that :
	a) Either you get your card registered and try again.
	b) Else send us your application through post along with the Demand Draft.

ADD PHOTO

* Passport size photograph only.

All fields marked * are mandatory.

Please indicate nature of your application:

RegularCorporate Sponsored

* Select payment mode :

1. Personal Details (Block Letters)

* Last Name :

* First Name :

Middle Name :

* Date of Birth :

Gender:

MaleFemale

* Nationality:

Marital Status:

Father's Name & Occupation:
Mother's Name & Occupation:

2. Contact Details

* Address (for correspondence)

* City:	* State:	* Pin:

* Telephone No:	* Mobile:

* Email:

3. Valid Entrance Test Score (Tick the applicable)

CATMATXATGREGMAT

Percentile Score :

(Test scores of last two years are valid for consideration)
(Please bring original copy of the Admit Card at the time of Personal Interview, if short-listed)

ELSE

Apply for JIMAT (Jaipuria Institute of Management Admission Test)

YesNo

Centers for GDLE & Personal Interview (PI):
(Please tick any three centers of your preference and rank them)

New Delhi Chennai Kolkata Mumbai Bengaluru Hyderabad Indore Lucknow Bhopal Patna Vadodara

4. Education

Name of Examination	Year	Marks/ Grade (%)	Major Subjects	Board / Academic University	Awards / Prizes received
*Bachelor's Degree
Other Examination

5. Work Experience (only full time after graduation)

Sr. No.	Position Held	Nature of Work	Name of Organization	Period/Months
1
2
3
4

6. Explain the need of management education for the success of an organization? (in 100 words)

7. Explain your career goals in the next 5 years.

8. List any three significant achievements/awards which you would particularly like to mention.

9 . Declaration I have carefully read the instructions and agree to abide by the decisions of the Institute regarding my selection to the programme. I certify that the information furnished in this application form is correct to the best of my knowledge and belief.

* Place:
* Date:

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