INDIAN INSTITUTE OF MANAGEMENT TIRUCHIRAPPALLI FELLOW PROGRAMME in MANAGEMENT Admissions 208 Instructions for Filling Admission Form 208: General Instructions:. This 0 page form is divided into three parts. a. Part : Consist of instructions to fill the form (page -2). b. Part 2: Consist of sections that are to be filled in exclusively by you to represent yourself and your candidature (page 3-7). Please refer to the section wise instructions on how to fill them. c. Part 3: Consist of the Letter of Recommendation (page i iii). Please refer to the instructions provided under Section 9 of this instruction sheet on how to fill them. 2. Please tick ( ) or fill all the sections as instructed. 3. Please fill the form in BLOCK LETTERS. 4. Last date for the submission of this application form is January 22, 208 and last date for payment of the application fee is January 5, 208. 5. The completed application form must be sent to: Admissions Office, Indian Institute of Management Tiruchirappalli, Pudukottai Main Road, Chinna Sooriyur Village, Tiruchirappalli - 620 024. Tel: 043-2505026 Section-wise Instructions:. In Section : a. Please tick the area (only one) you are applying to. b. If you are applying to more than one area please use separate application forms. 2. In Section 2: a. Please enclose an attested copy of SC/ ST/ NC-OBC/ DAP Certificate (if applicable). 3. In Section 3: a. Application fee of Rs.500/- (No fee for SC / ST / DAP candidates.) to be remitted through NEFT SB A/c No.: 3270808935; In favour of: Indian Institute of Management Tiruchirappalli; IFSC Code: SBIN00067; Branch Details: SBI, NIT Campus before 5 January, 208. b. Kindly attached a copy of the screen shot of the NEFT payment made. c. If applying to more than one area, application fee needs to be paid separately for each area application. 4. In Section 4: a. Please enclose a self-attested copy of relevant entrance examination score sheets.
5. In Section 5: a. Please mention your academic details from high school onwards in reverse chronological order. b. Please attach self-attested copies of your mark sheet and certificates wherever applicable. c. If required, please attach separate sheets and reference the additional sheets in this section of the form. 6. In Section 6 to 8: a. If required, please attach separate sheets and reference the additional sheets in this section of the form. 7. In Section 9: a. Please attach two letters of recommendations in sealed envelopes signed by the recommenders across the seal. b. This process will need to be followed for each separate application you submit, for example, if you apply to two areas, and are therefore submitting two application forms, you need to enclose separate recommendation letters to both areas, even if the same recommenders are providing the letter for both areas. c. Recommenders should be persons who are in a position to comment on your candidature. d. At least one recommender should be a faculty member of a University/ College/ Institute of advanced learning. e. An application will be treated as incomplete without the two recommendation letters. f. Instructions for submitting these letters are contained in the enclosed recommendation forms. Blank forms of recommendation is enclosed. g. Please fill Part A of the recommendation letters, Part B must be filled by the person recommending your candidature into the FPM program. 8. In Section 0: a. Please sign the declaration verifying the authenticity of the content filled in this form. 9. In Section : a. Please go through the checklist and tick mark ( ) all items completed on it. 2
INDIAN INSTITUTE OF MANAGEMENT TIRUCHIRAPPALLI FELLOW PROGRAMME in MANAGEMENT Admission Form 208 PLEASE ENSURE THAT YOU HAVE READ THE INSTRUCTIONS MENTIONED AT THE START OF THIS FORM Section : Area of Specialization Area of Specialization (tick one): Finance and Accounting Organizational Behaviour & Human Resource Management Marketing Operations Management & Quantitative Techniques Strategy Section 2: Personal Details - Part 3 2 Name: Father s/ Guardian s Name: (As in School Leaving Certificate) Affix Your Recent Passport Size Photograph Here 4 5 Gender: Male Female Marital Status: Single Married 6 Date of Birth (DD/MM/ YY): 7 Nationality: 8 Contact Details: Permanent Address: Mailing Address E-Mail Address: PIN: PIN: Telephone No.: Mobile No.: 3
Section 2: Personal Details - Part 2 Which Category do you belong to: A. SC C. NC-OBC B. ST D. Others 2 Are you disabled/ Differently Abled Person (DAP) (as defined in the Persons with Disability Act, 995)? E. Yes F. No State of Domicile: Section 3: Remittance of Application Fee NEFT Transaction No. Date of Remittance Name and Area applied - mentioned in the remarks column of the NEFT payment Section 4: Details of Admission Tests: Please tick the admission test you have taken: 2a 2b CAT GMAT GATE GRE UGC-JRF Please fill the following columns if you are applying through CAT: Test Registration Number (Available in your admit card received upon successful registration CAT Percentile Please fill this table if you are not applying through CAT. In the first column, fill in the name of the test. In the subsequent columns provide detailed scores/ percentile for each section assessed in the test: Section Name Test Name e.g. Verbal Section e.g Score e.g. Percentile e.g. GMAT 4
Section 5: Details of Academic Record Name of the Degree/ Certificate/ Diploma in reverse chronological order Institution From Period To Subjects taken Major & Minor Class/Grade/ Division/ % of marks Section 6: Details of Work Experience Name & Address of Employer Designation Date From To Remuneration (per month) Nature of Work Section 7: Details of Honours, Awards and Distinctions Received Sr. No. Approving / Nominating / Recognizing Body Bestowing the Honour/ Award / Distinction Month and Year Brief Details of Award / Reward / Recognition e.g. Delhi University e.g. April, 206 e.g. Gold Medalist, M.A (Economics) 5
Section 8: Statement of Purpose Briefly but clearly state your research interest that leads you to apply to the Fellow Program in Management at IIM Tiruchirappalli: 2 Why do you think you should be selected, given your career goals, personal attributes/ achievements? 3 In case you have applied to two areas of specialization, please give the reason for doing so and justify why you have applied to the other area: 6
4 Please state any other information that you would like to provide in support of your candidature: Section 9: Name and addresses of recommenders 2 Name: Address: Name: Address: PIN: PIN: Section 0: Declaration by the candidate I certify that the information given by me in this application is correct. Date: Place: Signature of Applicant Section : Checklist Please ensure you have Filled out all sections in this form and the relevant sub sections within it. 2 Tick marked ( ) only one area of specialization in this form to indicate your preference. 3 Affixed your recent passport size photograph. 4 Attached an attested copy of SC/ ST/ NC-OBC certificate (If applicable). 5 Attached an attested copy of DAP certificate (If applicable). 6 Attached a self-attested copy of entrances examination score sheet. 7 Paid the application fee and attached a copy of the screenshot of the NEFT Payment mode (If applicable). 8 Attached a self-attested copy of all academic mark sheets and certificates. 9 Attached a self-attested copy of all work experience certificates. 0 Attached two sealed and signed letters of recommendation. 0 Attached a self-attested copy of any other documents to support your candidature (list below): 3 2 4 7
Letter of Recommendation Part A: To be completed by the Applicant Name of Applicant: Area Applied for (Please tick only one area for which this letter is applicable) Finance & Accounting Marketing Operations Management and Quantitative Techniques Organizational Behaviour & Human Resource Management Strategy Date.. Signature of Applicant.. Part B: To be completed by the person providing reference Thank you for agreeing to fill out this recommendation letter. The above candidate has applied to the Fellow Programme (equivalent to a doctoral programme) of IIM Tiruchirappalli. After filling out there commendation form, please place it in an envelope, seal the envelope, and sign across the seal. Hand over the sealed envelope to the applicant, and instruct him/ her to submit your sealed envelope along with his/her completed application form to Admissions Office, Indian Institute of Management Tiruchirappalli, Pudukottai Main Road, Chinna Sooriyur Village, Tiruchirappalli - 620 024. Details about the applicant I know the applicant for years. He/She has been (tick the appropriate answer) Student in my course(s) A personal friend or acquaintance My advisee Others (Please Specify) i
I would rank him/her as indicated below (please tick as appropriate) Category Excellent Very good Good Fair Poor Academic Strength Motivation Teaching Potential Ability to work independently Attention to detail Ability to take initiative Research Potential Writing ability Speaking ability Overall Rating No basis for judgment Strengths of the candidate (please use additional sheets if necessary): Weaknesses of the candidate (please use additional sheets if necessary): ii
Comments on the candidate s suitability to pursue a doctoral level programme (please use additional sheets if necessary) Details of the person providing reference Name Designation_ Signature and Date _ Affiliation Address Phone Number(s) Email iii