Application forDual Degree in Global Supply ChainManagement (2015-16 Batch)

Application No: IIMU/..

Full Name :Email

Gender :D.O.B.

Country of Origin :Age

Current Country :Citizenship

Contact Details :

Address :

City :State

Country :Email

Ph [O] :Ph [R]

Ph [M] :

General Details :

GMATTOEFL

Code :Code

Date :Date

Verbal :Writing

Quantitative :Speaking

AWA :Listening

Total :Reading

Total

Area of Expertise: (mark in the following manner: 0=no experience, 1=low, 2=moderate, 3=high)

General Management : Sales :

Strategic Management : Production / Operations :

Accounting & Control : Service Operations :

Finance & Finance Analysis : H.R.M. :

Project Management : Information Technology :

Marketing : Research & Development :

Current Employment :

Employment status :Working Since :

Designation :Managerial :

Functional Area :

Company :

Industry Type :

Web Address : http://www. Responsibilities :

No. of people reporting you:

Designation of the person you report to:

Annual Turnover:Assets Under Your Management:

Annual Gross Salary:

Address :

City :Pin Code :

State :Country :

Phone :Fax :

Company Endorsement :

1) Is your organization willing to provide you with financial assistance to meet the cost of theprogramme? Yes/No2) Are they agreeable to provide you with facilities to undertake an in-company project during the programme? Yes/No

Major Accomplishment:

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4)

Total previous experience (Years).:

Employment History:

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Designation:Managerial:

Industry:No. of people reporting to you:

Function:Annual Gross Salary:

Major Accomplishment:

1)

2)

3)4)

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Designation:Managerial:

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Industry:No. of people reporting to you:

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International Exposure:

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Description:

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Self /Career Improvement Efforts:

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Language Proficiency:

Mother Tongue/Native Language:

Sr.LanguageReadingWritingSpeaking

Application submitted on: / / 2014