INSTITUTE OF BUSINESS AND MANAGEMENT, UET LAHORE EXECUTIVE MBA

							                    INSTITUTE OF BUSINESS AND MANAGEMENT, UET LAHORE                                     Photograph

                    EXECUTIVE MBA (EMBA) PROGRAM APPLICATION FORM

     1. PERSONAL DETAILS
     First Name:
     Father’s Name:

     Date of Birth:                                              NIC No:
     Nationality:


     2. CONTACT DETAILS
     Complete Address:


     Home Telephone (with code):                                         M obile Telephone:
     Office Telephone (with code):
     Primary E-mail Address:


 3. EDUCATION
 Please list all the universities and colleges attended, starting with the most recent.
        DATES                        NAM E OF INSTITUTIONS &                     MAJOR SUBJECT   DEGREE      RESULT
     FROMTO                              LOCATION                                                AWARDED     (DIV/CGPA)
     YY/MM YY/MM




4.       SCHOLARSHIPS/DISTINCTIONS/AWARDS

Please list academic scholarships, awards, honours or distinctions.

     DATE                  NAM E OF AWARD/PRIZE                          REASON FOR AWARD        AM OUNT/SIGNIFICANCE
     MM /YY




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5. CAREER OVER VIEW
Starting with your current/most recent position, list your employment details.

      DATES                           COM PANY/LOCATION                          JOB TITLE         JOB

 FROM           TO                                                                           RESPONSIBILITY

MM /YY      MM /YY




      7. CAREER OBJECTIVES

      a. Describe your current/most recent professional role in your organization.




      b. What were your achievements in your most recent professional experience?




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    c. What are your career objectives and how will an Executive MBA help you achieve them?




    8. INFOR MATION ABOUT IBM

How did you learn about the IBM ? Please tick the appropriate choice.

                Newspaper Ad                                       Internet Search Results

                UET Website                                        IBM Website

                Other (Please Specify)




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    9. REFERENCES DETAILS AND CONTACTS

Please provide the details of two referees who have direct knowledge of your professional or academic
capabilities.




Referee 1

    a. Name:

    b. Designation:

    c. Organization:

    d. Work Telephone:

    e. M obile:

    f.   E-mail:




Referee 2

    a. Name:

    b. Designation:

    c. Organization:

    d. Work Telephone:

    e. M obile:

    f.   E-mail:




These referees should provide an independent review of your professional or academic capabilities by filling
out forms provided at the end of this application. These forms should be sealed in an envelope which should be
signed at the back and attached with this application form.




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       DECLARATION

       The Institute of Business Administration reserves the right to refuse admission or cancel an offer of admission
       without any notice or reason. Please read the following statement carefully before you sign the application.

       I certify that all the information given in this application is complete and accurate. Details of qualifications and
       work experience may be checked with organizations and authorities concerned. I understand that any
       misrepresentation or omission of information in this application may result in denial of admission, cancellation
       of admission or expulsion from the program and the Institute of Business Management, UET Lahore reserves
       the right to take legal action against me if necessary.


       By signing this certificate I am authorizing the mentioned organizations to disclose/verify the claimed
       information to IBM.



       Signature of Applicant:             _________________________

       Date:                               ________________________




           10. APPLIC ATION FOR M CHECK LIST

       Please ensure that the following documents are attached with this application form and CHECK/TICK the
       attached documents:



  i.       Completed Application Form


 ii.       Two Photocopies of National Identification Card, Academic Transcripts & Degrees and Certificates.


iii.       Four Passport Sized Photographs


iv.        Two References to be sealed in separate envelopes, duly signed at the back

            and attached with this form


 v.        Bank Draft of Rs. 2000/- in favour of IBM, UET Lahore as application processing fee




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INSTITUTE OF BUSINESS AND MAN AGEMENT, UET

1.         REFERENCE FORM

Name:

Designation:

Organization:

Work Telephone:

M obile:

E-mail:

Date:

Kindly fill out the following information about

M r./Ms/M rs.___________________________________________________________________________

for consideration of application in the ________________________ program at Institute of Business

M anagement, UET Lahore.




     1. How long have you known the applicant for?




     2. In what capacity have you known the applicant?




     3. Please comment about the applicant’s professional, academic, team work and leadership

           capabilities:




     4. Please mention an achievement of the applicant that may have proved useful for your

           organization.



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    5. Please provide any other (negative or positive) information that you may deem necessary about

        the applicant.




    6. In which category would you rate the applicant in terms of his/her capabilities compared to the

        rest of the applicant’s peers/colleagues:




               Top 5%                Top 10%                  Top 20 %                  Top 30%




I declare that the information contained in this letter, is to the best of my knowledge correct. Should you need
more information please contact me.




Signatures: ____________________________________

Date: ________________________________________




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INSTITUTE OF BUSINESS AND MAN AGEMENT, UET

    2. REFERENCE FORM

Name:

Designation:

Organization:

Work Telephone:

M obile:

E-mail:

Date:

Kindly fill out the following information about

M r./Ms/M rs.___________________________________________________________________________

for consideration of application in the ________________________ program at Institute of Business

M anagement, UET Lahore.




    1. How long have you known the applicant for?




    2. In what capacity have you known the applicant?




    3. Please comment about the applicant’s professional, academic, team work and leadership

           capabilities:




                                                                                                    8
    4. Please mention an achievement of the applicant that may have proved useful for your

        organization.




    5. Please provide any other (negative or positive) information that you may deem necessary about

        the applicant.




    6. In which category would you rate the applicant in terms of his/her capabilities compared to the

        rest of the applicant’s peers/colleagues:




               Top 5%                Top 10%                  Top 20 %                  Top 30%




I declare that the information contained in this letter, is to the best of my knowledge correct. Should you need
more information please contact me.




Signatures: ____________________________________

Date: ________________________________________




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