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Name
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Entertainment/Media
Entrepreneur,
FMCG
Government
Hospitality
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Internet
Investment Banking
IT/ITES
Logistics
Manufacturing
Marketing
NGO
Pharmaceuticals
Real Estate
Retail
Retail Banking
Telecom
Any other (please specify)
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Address2
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Address3
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City
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Tele No.
Fax
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About me:
You could include information such as past companies worked for and job profiles,
manta in life, your interest (in not more than 500 words).
Payment:
Please send demand draft / pay order of Rs.1,000/- (Rupees One Thousand Only) towards
one-time registration charges in favour of Indian Institute of Management Indore, payable
at Indore.
Payment details
Draft No.: ___________________Dated: _____________ Amount (Rs.)____________
Drawn on (Bank): _______________________________________________________
Important
Please enclose copy of your recent photo-identity document along with the form.
Date:__________________
______________________
Place: _________________
(Signature)