Application Form

Post Graduate Diploma in Management (2018-20)

(Approved by AICTE)

Father's Name:
Lodhi Road Gurgaon Greater Noida
1. Read the application form carefully before you fill it.

2. Please use tick marks (√) in appropriate boxes wherever required, except for question on academic concentration / major where you need to list in numbers. Please re-check the form to ensure you have not left any data un-filled.

3. If there is not enough space for your answers, you can use additional page.

4. All information you provide will only be used by our Admission Department and will remain confidential.

5. The information contained in this prospectus is of general nature for the students seeking admissions in various programmes offered by this institution. It is neither an exhaustive nor a legal document. Every effort has been made to ensure that the information in this Prospectus is correct at the time of compilation. IILM Institute, however, reserves the right to make changes wherever and whenever necessary. In the event of inconsistency between the information contained in the Prospectus and the Institute’s regulations or Programmes where an interpretation of the Prospectus is required, the decision of the Institute shall be final. The Prospectus does not form any part of a contract between any person and the Institute. Management reserves its right to alter or modify the structure of any of the programs to attain the objective of excellence. Management does not take any responsibility for any oral/verbal assurance by any person and student is advised to refer to the latest student handbook available in the institute office or seek written clarification from the Director.
Personal Data
Gender: Male Female Blood Group
Date of birth (DD/MM/YY)
Correspondence Address
City/Town State
Country Pincode
Permanent Contact details with STD code
E-mail address Mobile
Academic Qualifications
  Class X details Class XII details
Aggregate of all subject(Marks / %age)
Year of Passing
Graduation Stream
Name of University and College
  Class X details
Aggregate of all subject(Marks / %age)
Year of Passing
Name of School/College
Work Experience (if applicable)
Designation Duration  
Job Profile
Test appeared for
Test Date Taken/To be Taken Language Score Math Score Total Percentile / Score
Mother’s name Father’s name
Permanent Residence Address Permanent Residence Address
Occupation Occupation
Name of business or organization Name of business or organization
Education Education
Parent’s Mobile/Email
Please give names of local guardian and contact details
Other Achievements
Briefly describe any scholastic awards or scholarships you have received
Any past medical history records(if Yes ,please specify)
Have you at any time been convicted by a court for any criminal offence? If so, give name of the court case number and offence.
How did you get to know about IILM?
Newspaper: (Name) IILM Website Facebook Alumni
Coaching Institute: Others
Have any of your relatives or friends studied in any of our Programmes? Yes No
Name Programme Year

Declaration by Applicant:

I declare that all information in my application is complete, factually correct, and honestly presented. I have read the rules and regulations mentioned in the prospectus and will adhere to the same.
Attach Signature

This information contained in this form will be used for the purpose of processing your application and, if it is successful, it will form the basis of your Institute record. Please return the completed application with all required documents. This form is free; no payment is required at the time of form submission.