Indian Institute of Management Lucknow
CERTIFICATE PROGRAMME IN BUSINESS
ANALYTICS FOR EXECUTIVESInstructions and Guidelines for Admission
1. Applicants should have Bachelor’s Degree in any discipline with a minimum of 60%
aggregate marks or equivalent in graduation and a minimum of three years full-time post
qualification work experience as on October 20, 2013. For applicants with exceptional
qualification and/or industry experience, a relaxation in the minimum eligibility criteria
may be considered. Preference will be given to applicants with Post-Graduation/
Graduation in Mathematics, Engineering, Economics and Statistics. Also, executives
working in the domain of Business Analytics are especially encouraged to apply.
2. It is very important that all candidates should carefully read the procedure and follow the
steps for admission of CPBAE 2013 - 14 Programme. Kindly call us if instructions are not
clear or you have a specific issue.
3. The Institute reserves the right to cancel / postpone this program.
Admission Procedure
1. Fill up the application form and send the same along with the self-attested photocopies of
testimonials/official transcripts and a Demand Draft for Rs. 1000/- (Rupees One Thousand) only
(non-refundable) drawn in favor of “Indian Institute of Management Lucknow”, payable at
Lucknow, towards the cost of application form.
2. Application Form along with Demand Draft of Rs. 1000/- should reach The Programme
Manager, Management Development Programme, Indian Institute of Management, Prabandh
Nagar, Off Sitapur Road, Lucknow - 226013 on or before 25th October, 2013.
3. The admission team will shortlist the candidates based on past academic performance, work
experience and other achievements.
4. Notification of short listed candidates by IIM Lucknow will be available on our website
http://www.iiml.ac.in latest by November 10th , 2013. Offer letter will be sent to all the selected
candidates separately.
5. Last date of Acceptance Fee Rs. 80,000 (non-refundable) is 5th December, 2013
6. Kindly present all original testimonials/official transcripts and self–attested photocopies at the
time of admission for verification. The originals shall be returned after verification.
Fee Structure
Total fees for this programme is Rs. 4,80,000 /- (inclusive of taxes) and is payable in four
installments. Fee includes tuition fee, accommodation (twin sharing basis) and food for the
duration of residencies and course material. Participants will have to bear their travel expenses
for attending residencies. All fee are non-refundable.
Application Fee Rs. 1000/-
Programme Fee Rs. 4,80,000 /- (Inclusive of Taxes)
Installment Details
Installment Last Date for Payment Amount
I At the time of confirmation, latest by 5th
December, 2013 (non-refundable)
Rs 80,000
II December 27, 2013 Rs. 2,00,000
III March 14, 2014 Rs. 1,00,000
IV June 06, 2014 Rs. 1,00,000APPLICATION FEE DETAILS
AMOUNT Rs. 1000/-
DEMAND DRAFT NO.
DATED (DD/MM/YY) / /
BANK NAME
Certificate Programme in Business Analytics for Working Executives
Instructions:
APPLICATION FORM
1. Complete the application form in CAPITAL letters only. Use common abbreviations for courses, degrees, certificates,
university names, etc.
2. In all matters relating to admission, the decision of the Indian Institute of Management Lucknow (IIML) will be final
and binding on the applicant. No correspondence will be entertained from the applicant regarding his/her non-selection.
3. Self-attested photocopies of testimonials/official transcripts and a Demand Draft for Rs. 1000/-(Rupees One Thousand)
only (non-refundable) drawn in favor of. “Indian Institute of Management Lucknow”, payable at Lucknow,
towards the cost of application form should be submitted along with the filled-in application. Self-attested
4. The applicant will be required to present all original testimonials / official transcripts at the time of admission.
5. This form is a key part of the admission process. Complete and accurate information is, therefore, extremely important.
Incomplete or false information will make your candidature null and void.
Paste recent passport
size photograph
3.5 cm X 3.5cm
A. PERSONAL DATA
A1. Name
(First Name) (Middle Name) (Last Name)
A2. Gender Male Female
A3. Date of Birth
DD MM YYYY
A4. Address for correspondence
A5. E-mail id:
A6. Telephone No. with STD Code Cell phone No.
A7. Nationality B. PROFESSIONAL FULL -TIME WORK EXPERIENCE
B1. Total Work Experience as on October 20, 2013. Years Months and Days
B2. Provide the following details of your work experience starting with your current employment. Do not include
training, project work, work done as an integral part of curricular requirement, and part-time work.
From
(DD/MM/YY)
To
(DD/MM/YY)
Total
completed
Months
Name of the organization Designation
B3. Are you sponsored by your organization: Yes No C. ACADEMIC QUALIFICATIONS
C1. Pre-Bachelor’s Degree Examination(s):
Std. School / Institution Board / University Year
completed
Max.
Marks
Total
Marks
Obtained
% Marks
Obtained
Class/
Division
10th
12th
C2. Bachelor’s Degree Examination(s):
Degree Obtained Subject/
Specialization
College/Institute University
Year Date
From To Max. Marks/
Max. GPA
Marks/GPA
Obtained
% Marks
Obtained
1
st Year
2
nd Year
3
rd Year
4
th Year
5
th Year
Total / CGPA
Class / Division Awarded
C3. Master’s Degree / Post-Graduation:
Degree Obtained Subject/
Specialization
College/Institute University
Year Subject Max.
Marks
Marks
Obtained
% of
Marks
Obtained
From To
1
st Year
2
nd Year
Overall percentage of marks obtained
C4. Any other professional qualification (or Additional Degrees):
Qualification College / Institute Programme Name & DurationD. ADDITIONAL INFORMATION, IF ANY
E. DECLARATION
I have carefully read the instructions and agree to abide by the decision of the Indian Institute of
Management Lucknow authorities regarding my selection for the programme. I certify that the
particulars given by me in this form are true to the best of my knowledge and belief. I know that
at any time if the information furnished by me is found incorrect my candidature will be
cancelled immediately.
Place: _________
Date:
Signature of Applicant
Note: - Send the complete application form along with application fee latest by
25th October 2013 to the following address:
Officer–In–Charge (MDP)
Indian Institute of Management Lucknow
Prabandh Nagar, Off-Sitapur Road,
Lucknow – 226 013 (UP) India
Phone: (0522) 3290224, 2736282, 6696282
E- Mail: cpbae2@iiml.ac.in
IIM Lucknow website: www.iiml.ac.inF. STATEMENT OF PURPOSE
Describe your career goals and your reasons for wishing to undertake the Certificate
Programme in Business Analytics for Executives offered by Indian Institute of
Management Lucknow and Kelley School of Business, Indiana University, USA (Max 100
words).
Name____________________________________Signature___________________________________
CERTIFICATE PROGRAMME IN BUSINESS
ANALYTICS FOR EXECUTIVESInstructions and Guidelines for Admission
1. Applicants should have Bachelor’s Degree in any discipline with a minimum of 60%
aggregate marks or equivalent in graduation and a minimum of three years full-time post
qualification work experience as on October 20, 2013. For applicants with exceptional
qualification and/or industry experience, a relaxation in the minimum eligibility criteria
may be considered. Preference will be given to applicants with Post-Graduation/
Graduation in Mathematics, Engineering, Economics and Statistics. Also, executives
working in the domain of Business Analytics are especially encouraged to apply.
2. It is very important that all candidates should carefully read the procedure and follow the
steps for admission of CPBAE 2013 - 14 Programme. Kindly call us if instructions are not
clear or you have a specific issue.
3. The Institute reserves the right to cancel / postpone this program.
Admission Procedure
1. Fill up the application form and send the same along with the self-attested photocopies of
testimonials/official transcripts and a Demand Draft for Rs. 1000/- (Rupees One Thousand) only
(non-refundable) drawn in favor of “Indian Institute of Management Lucknow”, payable at
Lucknow, towards the cost of application form.
2. Application Form along with Demand Draft of Rs. 1000/- should reach The Programme
Manager, Management Development Programme, Indian Institute of Management, Prabandh
Nagar, Off Sitapur Road, Lucknow - 226013 on or before 25th October, 2013.
3. The admission team will shortlist the candidates based on past academic performance, work
experience and other achievements.
4. Notification of short listed candidates by IIM Lucknow will be available on our website
http://www.iiml.ac.in latest by November 10th , 2013. Offer letter will be sent to all the selected
candidates separately.
5. Last date of Acceptance Fee Rs. 80,000 (non-refundable) is 5th December, 2013
6. Kindly present all original testimonials/official transcripts and self–attested photocopies at the
time of admission for verification. The originals shall be returned after verification.
Fee Structure
Total fees for this programme is Rs. 4,80,000 /- (inclusive of taxes) and is payable in four
installments. Fee includes tuition fee, accommodation (twin sharing basis) and food for the
duration of residencies and course material. Participants will have to bear their travel expenses
for attending residencies. All fee are non-refundable.
Application Fee Rs. 1000/-
Programme Fee Rs. 4,80,000 /- (Inclusive of Taxes)
Installment Details
Installment Last Date for Payment Amount
I At the time of confirmation, latest by 5th
December, 2013 (non-refundable)
Rs 80,000
II December 27, 2013 Rs. 2,00,000
III March 14, 2014 Rs. 1,00,000
IV June 06, 2014 Rs. 1,00,000APPLICATION FEE DETAILS
AMOUNT Rs. 1000/-
DEMAND DRAFT NO.
DATED (DD/MM/YY) / /
BANK NAME
Certificate Programme in Business Analytics for Working Executives
Instructions:
APPLICATION FORM
1. Complete the application form in CAPITAL letters only. Use common abbreviations for courses, degrees, certificates,
university names, etc.
2. In all matters relating to admission, the decision of the Indian Institute of Management Lucknow (IIML) will be final
and binding on the applicant. No correspondence will be entertained from the applicant regarding his/her non-selection.
3. Self-attested photocopies of testimonials/official transcripts and a Demand Draft for Rs. 1000/-(Rupees One Thousand)
only (non-refundable) drawn in favor of. “Indian Institute of Management Lucknow”, payable at Lucknow,
towards the cost of application form should be submitted along with the filled-in application. Self-attested
4. The applicant will be required to present all original testimonials / official transcripts at the time of admission.
5. This form is a key part of the admission process. Complete and accurate information is, therefore, extremely important.
Incomplete or false information will make your candidature null and void.
Paste recent passport
size photograph
3.5 cm X 3.5cm
A. PERSONAL DATA
A1. Name
(First Name) (Middle Name) (Last Name)
A2. Gender Male Female
A3. Date of Birth
DD MM YYYY
A4. Address for correspondence
A5. E-mail id:
A6. Telephone No. with STD Code Cell phone No.
A7. Nationality B. PROFESSIONAL FULL -TIME WORK EXPERIENCE
B1. Total Work Experience as on October 20, 2013. Years Months and Days
B2. Provide the following details of your work experience starting with your current employment. Do not include
training, project work, work done as an integral part of curricular requirement, and part-time work.
From
(DD/MM/YY)
To
(DD/MM/YY)
Total
completed
Months
Name of the organization Designation
B3. Are you sponsored by your organization: Yes No C. ACADEMIC QUALIFICATIONS
C1. Pre-Bachelor’s Degree Examination(s):
Std. School / Institution Board / University Year
completed
Max.
Marks
Total
Marks
Obtained
% Marks
Obtained
Class/
Division
10th
12th
C2. Bachelor’s Degree Examination(s):
Degree Obtained Subject/
Specialization
College/Institute University
Year Date
From To Max. Marks/
Max. GPA
Marks/GPA
Obtained
% Marks
Obtained
1
st Year
2
nd Year
3
rd Year
4
th Year
5
th Year
Total / CGPA
Class / Division Awarded
C3. Master’s Degree / Post-Graduation:
Degree Obtained Subject/
Specialization
College/Institute University
Year Subject Max.
Marks
Marks
Obtained
% of
Marks
Obtained
From To
1
st Year
2
nd Year
Overall percentage of marks obtained
C4. Any other professional qualification (or Additional Degrees):
Qualification College / Institute Programme Name & DurationD. ADDITIONAL INFORMATION, IF ANY
E. DECLARATION
I have carefully read the instructions and agree to abide by the decision of the Indian Institute of
Management Lucknow authorities regarding my selection for the programme. I certify that the
particulars given by me in this form are true to the best of my knowledge and belief. I know that
at any time if the information furnished by me is found incorrect my candidature will be
cancelled immediately.
Place: _________
Date:
Signature of Applicant
Note: - Send the complete application form along with application fee latest by
25th October 2013 to the following address:
Officer–In–Charge (MDP)
Indian Institute of Management Lucknow
Prabandh Nagar, Off-Sitapur Road,
Lucknow – 226 013 (UP) India
Phone: (0522) 3290224, 2736282, 6696282
E- Mail: cpbae2@iiml.ac.in
IIM Lucknow website: www.iiml.ac.inF. STATEMENT OF PURPOSE
Describe your career goals and your reasons for wishing to undertake the Certificate
Programme in Business Analytics for Executives offered by Indian Institute of
Management Lucknow and Kelley School of Business, Indiana University, USA (Max 100
words).
Name____________________________________Signature___________________________________
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