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Indian Institute of Management Visakhapatnam
Gambheeram Village, Anandapuram Mandal,
Visakhapatnam – 531 163
Andhra Pradesh, INDIA.
Tel: +91 8912824561

POST GRADUATE CERTIFICATION IN ENTREPRENEURSHIP

IIMV-SIDBI STEM PROJECT

Application form

Note: Applications are invited exclusively from candidates residing in Andhra Pradesh and Telangana.

Instructions:

Please use the format given below only and provide complete data. No CV needs to be attached separately.
Please read very carefully the instructions given in the detailed advertisement (hosted on: https://iimv.ac.in/careers) and ensure you are eligible, before applying.
Application should be completely filled-in and sent through email on iimv-sidbiproject@iimv.ac.in

B. Application for Candidates Applying to IIMV and SIDBI Certification Program

Name (in capital letters, with surname/last name in the end)

Upload Photo

Date of Birth (dd/mm/yyyy): Maximum is 40 years (eligible 22-25 years)

Communication Address

Contact No:

E-mail:

Marital Status:

Gender:

Family Income (Annual in INR):

Family occupation: Father and Mother

Current occupation of the applicant:

Education Details:

Exam

Qualification

Subjects / Specialization (if any)

Institution/University

Mode of Study [Full-time only]

Year of Passing

Aggregate Marks / Percentage / CGPA

X Std

10+2 / Intermediate

Diploma

Graduation

Post-Graduation

Post-Graduate Diploma

Others (Please specify)

Work Experience Details (List in reverse chronological order)

Name of the Employer

Period (From)

Period (To)

Duration (Years Months)

Employment Type (Regular / Contractual)

Monthly income in INR

Designation

Key Responsibilities

Please describe key job responsibilities handled in detail for every position

Proficiency in Languages (Telugu, English and Hindi): Please Write “YES” or “NO” as applicable

Language

Read

Write

Speak

Are you running any entrepreneurial venture?

Yes

Are you interested to Legally register your venture during the program

Yes

Would you be interested in investing 5 lakhs after registering the enterprise?

Yes

Description about the entrepreneurial idea for the program:

Statement of Purpose:

Please describe in about 300 words, why you wish to join this research project at IIM Visakhapatnam and how your qualifications & experience would be useful to the Institute in the certification program you are applying for.

Please share the listed documents below in a single pdf document : (SSC, Inter, Degree, Aadhar, Domicile/Nativity)

No file(s) selected

Declaration:

I hereby declare that all the statements and particulars furnished by me in this application are true, complete and correct to the best of my knowledge and belief. I declare that no facts/information has been hidden or suppressed. I also fully understand that in the event of any information furnished being found false, incomplete or incorrect at any stage, my application/candidature is liable to be summarily rejected forthwith and if I am already admitted, my services of joining the program will be terminated forthwith, without any notice or compensation; and without prejudice to any other legal/penal action that the Institute may initiate against me, as deemed fit.

Date

Place