New Delhi Institute of Management

Application Form

*Course Applied For:

*Name

*Mobile No:

*E-mail:

Date of Birth:

Category:

Gender:

*Complete Postal Address:

*City:

*Country

*Pin Code

*How did you learn about us: of Alumni:

Entrance Exam details:

CAT / XAT / CMAT / MAT / GMAT:

Score :

Percentile:

12^th details:

Completion year (Actual/Expected):

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Declaration By Candidate

I declare that the information furnished above is correct. I accept that incorrect information or withholding of relevant information may disqualify me. I agree to abide by the rules and regulations of the Institute.