PGDSCM Admission form

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Admission Form
APPLICANT DETAI L S (PLEASE COMPLETE
Title :
MR
MS
IN CAPI TAL LETTERS)
MRS
Full Name:
dd
Date of Birth:
Nationality :
CONTACT DETAILS
Curre nt Address:
Flat / Floor No.
House / Plot No.
Road / Block / Sec.
Thana / Area
Post code
City
Perm anent Address:
Mobile No.
Mobile No
. (alternate if Any)
E-mail:
mm
yyyy
DETAILS OF PARENTS / GUARDI ANS
Fathe r's Name:
Mot her's Name:
ACADEMI C INFORMATION:
Exam Name
School/College/Institute
Year attended
Group/Major
Board
S.S.C./O-Level
H.S.C./A-Level
Graduation
Post Graduation
EXPERIENCE
(Mention themost recent)
Employer:
From:
Location:
To:
I ndustr y
Type:
Designation:
Department:
Responsibili ty:
Phone:
Address:
Contact person:
E-mail:
Div/GPA/Class
SOURCE OF FINANCE
Self-financed
Family
Employer
PROGRAM SELECTED
Postgraduate Diploma in Human Resource Management (PGDHRM)
Postgraduate Diploma in Supply Chain Management (PGDSCM)
Certified Finance Specialist (CFS)
Diploma in Marketing
Qualified Internal Auditor (QIA)
MODE OF STUDY
Distance Learning
Part Time Learning
DECL ARATION
I HEREBY CONFIRM THAT ALL INFORMATION PROVIDED IN THIS ADMISSION FORM IS CORRECT AND
COMPLETE. IF I GET ADMISSION AT BiMS, I WILL ABIDE BY ALL THE RULES AND REGULATIONS OF THE
INSTITUTE. I ALSO UNDERSTAND THAT BiMS RESERVES THE RIGHT TO CHANGE ANY
REGULATIONS RELATING TO MY SELECTED QUALIFICATION.
Date of Application
dd
mm
Signature of the candidate
yyyy
OFFI CE USE ONLY
Ap plicat io n Resu lt:
Accepted
Rejected
Additional documents required
Batch:
Date of ad missi on :
Sign atur e