THE STOCK EXCHANGE, MUMBAI

REGISTRATION FORM FOR CPCM PROGRAMME

Name :_______________________________________

Age :_____________________   Sex : Male/Female
       (round off to nearest year)

Designation :___________________________

MailingMail to my office   Mail to my residence   

AddressOffice AddressResidence Address
  
  
  

Telephone No/s (O)________________________(R )____________________

Fax No/s________________________(R )____________________

Cell________________________Pager____________________

Email________________________



Educational Qualifications                          Experience (yrs) _________

Yr of passingDegree /DiplomaPercent /GradeUniversity
    
    
    

Payment Details : DD No. _______________________________ Dated __________________________

Amt. Rs. ________________ Drawn on Bank ______________________ Branch__________________

For office use only

Test Centre opted _________________ Test Centre Code________ Date Time opted ________________

Registration number ___________________________ (for office use only)

I declare that the information supplied above is true and correct to the best of my knowledge, information and belief. I undertake to abide by the terms and conditions of BOMBAY STOCK EXCHANGE LTD regarding the above-mentioned certification programme.

Place : __________________________________________
Date : __________________(Candidates Signature)



N.B:

Alongwith duly filled form
  • The candidates are requested to send the registration form with a Demand Draft of Rs.843/- (Rs. Eight Hundred and Forty Three), payable at Mumbai in favour of 'BOMBAY STOCK EXCHANGE LTD' and five copies of his passport size photograph for getting the Admit Card for the test.
  • The registration is given on first come first served basis.