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Post Graduate Diploma in Stock Markets

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1 Payment Details<br />

FORM NUMBER (For Official Use Only)<br />

Demand Draft Details<br />

D/D Number D/D Date D/D Amount<br />

/ /<br />

Date Month Year<br />

Bank name<br />

2 Name<br />

3 Father's/Husband's Name (do not write Shri/Mr./Dr. etc.):<br />

4(a) Address for Correspondence: House/ Flat No. Build<strong>in</strong>g, Street/Village/Mohalla (do no write Father's Or your name here)<br />

City District<br />

State P<strong>in</strong> Code<br />

4 (b) Telephone Number (with STD code) 4 (c) Mobile Number<br />

4(d) E-mail ID<br />

BSE INSTITUTE LIMITED - INDIRA GANDHI NATIONAL OPEN UNIVERSITY<br />

APPLICATION FORM FOR ADMISSION TO POST GRADUATE DIPLOMA IN STOCK MARKETS<br />

Write <strong>in</strong> English and CAPITALS. Use only Blue/Black Ball po<strong>in</strong>t Pen. One character <strong>in</strong> one Box. Do not write outside the boxes.<br />

Use of Green/Red Pen and Pencil is prohibited. Forms should be sent to The Admissions In - charge - PGDSM, BSE Institute Limited, BSE Ltd., 18th Floor,P.J.<br />

Towers, Dalal Street, Mumbai - 400001<br />

5 Sex: Cross (X) the appropriate box 6 Date of birth 7 Nationality: Cross (X) appropriate box<br />

Male Female / / Indian Other<br />

Date Month Year<br />

8 Category: Cross (X) the appropriate box<br />

General ST* SC*<br />

9 Marital Status: Cross (X) the appropriate box<br />

Married Divorced Widowed Unmarried<br />

10 (a) Educational Qualifications (which makes you eligible for the program)<br />

Attach attested xerox of all relevent documents.<br />

Year of Graduation Percentage of marks<br />

Name of College Name of University<br />

PASTE YOUR LATEST<br />

PASSPORT SIZE<br />

PHOTOGRAPH DULY<br />

ATTESTED BY YOU<br />

DO NOT STAPLE

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