INDIAN INSTITUTE OF EXPORT MANAGEMENT, BANGALORE
P.B.No. 7531, New Thippasandra, Bangalore – 560 075
Telefax: 91-80-5297318. Ph: 91-80-5292553

APPLICATION FOR ADMISSION TO DIPLOMA IN EXPORT MANAGEMENT

Please complete clearly in BLOCK LETTERS and mark in appropriate boxes. (Bold fields  have to be completed)

Title

Mr   Mrs   Ms       
Name
Address For Communication
Pincode
Phone
E-mail: (if available)
Date of Birth
Educational Qualification
University  / Institute / College
% Of Marks
Whether Employed Yes      No
Do you want to do the course ONLINE Yes      No
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Type of payment

Payment Details

Cash

  Rs    
Draft  No       Date

 Bank     

 Amount    

I have read the conditions applicable to the courses as described in the prospectus along with terms and conditions on application form and agree to abide by the same.

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