Education Degree (Start with Highest) Year College/University Work Experience Years of Organization (Start with Current) Position Experience Programmes Attended at IIMA Programme Title Duration Year Programmes Attended Elsewhere Institution Programme Title Duration Year Date:___________________ Signature:__________________ TO BE FILLED IN BY THE SPONSOR Sponsor Name Designation Organization Tax Deduction Account Number (TAN) Permanent Account Number (PAN) Office Address City Pin Country Mobile Phone Fax E-mail Information on Organization Total Assets Total Sales Turnover (Last Year) (Last Year) Major Products/Services Form of Organization Proprietary Partnership Public Sector Public Ltd. Others (Specify) Date:___________________ Signature:__________________ Please Indicate the Sources of Information of This Programme From Website (Yes/No) ______ Advertisement (Please Specify) _________ E-mail Received from Executive Education Brochure Received by Post (Yes/No) ______ Office (Yes/No) ______
Education Degree (Start with Highest) Year College/University Work Experience Organization (Start with Current) Position Years of Experience Programmes Attended at IIMA Programme Title Duration Year Programmes Attended Elsewhere Institution Programme Title Duration Year Date:___________________ Signature:__________________ TO BE FILLED IN BY THE SPONSOR Sponsor Name Designation Organization Tax Deduction Account Number (TAN) Permanent Account Number (PAN) Office Address City Pin Country Mobile Phone Fax E-mail Information on Organization Total Assets (Last Year) Total Sales Turnover (Last Year) Major Products/Services Form of Organization Proprietary Partnership Public Sector Public Ltd. Others (Specify) Date:___________________ Signature:__________________ Please Indicate the Sources of Information of This Programme Advertisement (Please Specify) _________ Brochure Received by Post (Yes/No) ______ From Website (Yes/No) ______ E-mail Received from Executive Education Office (Yes/No) ______