APPLICATION FORM
 
IIM CALCUTTA – LONG DURATION PROGRAMS (LDP)
Executive Program in Business & Corporate Laws (EPBCL)
 
First Name Last Name
Gender Male Female Date of Birth (dd/mm/yyyy)
Permanent Address City
Pincode    
Mobile Altername Mobile
Email ID Alternate Email ID
Address for Communication Same as above    
  City
Pincode Online Mode (D2D)
    Note: Pre-requisites for online mode - PC/Laptop, web camera, head phone with mic,
dedicated & stable internet connection with min 2 Mbps speed.
Preferred Class Location
(if not opting for ‘Direct to Device’)
(‘Min 3 participants needed per centre’)		 Upload Photo
Source of Information Google Search Email Social Media IIM Calcutta Website UCS (VCNOW) Kiosk Activity Newspaper
 
 Educational History:- Starting from higher secondary
Name of Examination Institute/University Specialization/Branch Year of Completion % of Marks
* Academic credentials will be verified after admission.
* At any point of time if any information is found to be incorrect, your admission will be cancelled.