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					                                                                                                                     FORM NO. SR-39

                                                                                    IMPORTANT : Before filling up the
                                                                                    application please visit Institute’s website
The Secretary & CEO
                                                                           and view overall status,
The Institute of Company Secretaries of India                                       incase of any discrepency, updation or
C-37, Sector-62, Institutional area                                                 modification including change of address
Noida -201 309                                                                      is required, please attach a separate letter
                                                                                    to enable us to       update the records
Ph : 4522072 – 4522073 E-mail :                               accordingly.


I wish to seek enrolment for undergoing coaching for the Professional Programme as I have passed both modules
(Groups) of the Executive Programme (Intermediate).The relevant information is furnished below :

∙   Regn No.                                                    /              /

∙   First Name (Ms. / Mr.)

Middle Name                                                                 Last Name

∙   E-mail:                                                            Mobile No:

∙    Details of Passing Intermediate Examination / Executive Programme
 Group/Module                         Session               Roll No.                             Year

∙      Fee Mode :
       (Refer code list No. I)
                                        D No./Ack .No./CB/SBS NO

       AMOUNT - _________________

Date :               /            /
Bank Code :
                                 (Refer code list No lI )

Bank Name
City :

Branch :

∙  Subject from which exemption sought on basis of passing Final exam of (Refer Code List No. III)
ICWAI Subject Code                       Subject                   Grant Date (for office use)

Date:                                                                                               Signature of Student

For Office use: (To be filled in by the Chapter / Region)

Study material issued by______________________ Chapter / Region
Signature of student on receiving the Study _______________________
                                               LIST OF CODES
              Code List I
                                     47 Vaish Cooperative Bank                               Code List III
FEE MODE CODES                       48 Bank of Madurai
                                     49 UCO Bank                           SUBJECT CODES
DD: Demand Draft                     50 The South Indian Bank Ltd.
                                     51 The Federal Bank Ltd.              Professional Programme- New Syllabus
BC Cash:Through Pay-in-slip of       52 The Lakshmi Vilas Bank Ltd.        Module - I
   Canara Bank                       53 Bharat Overseas Bank Ltd.          231 Company Secretarial Practice
BS Cash:Through Pay-in-slip of       54 The Catholic Syrian Bank Ltd.      232 Drafting, Appearances and Pleadings
   State Bank of Saurashtra          55 Tamilnad Mercantile Bank Ltd.      Module – II
CA Cash:Through Reception            56 Reserve Bank of India              233 Financial Treasury & Forex Management
   Receipt                           57 City Union Bank Ltd.               234 Corporate Restructuring & Insolvency
                                     58 The Tamil Nadu State Apex          Module – III
             Code List II                Co-Op Bank Ltd.                   235 Strategic Management, Alliances &
                                     59 The Delhi State Co-Op Bank Ltd.        International Trade
BANK CODES                           60 The Janalaxmi Co-Op Bank Ltd.      236 Advanced Tax Laws and Practice
                                     61 The Karur Vysya Bank Ltd.          Module – IV
01    Andhra Bank                    62 Global Trust Bank Ltd.             237 Due Diligence & Corporate Compliance
02    Allahabad Bank                 63 The General Co-Op Bank Ltd.             Management
03    ANZ Grindlays Bank             64 The Sangli Bank Ltd.               238 Governance, Business Ethics and
04    Bank of America                65 Lord Krishna Bank Ltd.                 Sustainability
05    Bank of India                  66 The United Western Bank Ltd.
06    Bank of Baroda                 67 The Nedungadi Bank Ltd.
07    Bank of Maharashtra                                                  Final – Old Syllabus
                                     68 Indusind Bank Ltd.                 Group – I
08    Bank of Tokyo
09    The Bank of Punjab Ltd.        69 The Karnataka Bank Ltd.            131 Advanced Company Law & Practice
10    Canara Bank                    70 Kanaka Durga Grameena Bank         132 Secretarial Practice relating to Economic
11    Corporation Bank               71 The Dhanlakshmi Bank Ltd.               Laws & Drafting & Conveyancing
12    Citi Bank                      72 Bareilly Corporation Bank Ltd.     133 Secretarial, Management & Systems
13    Dena Bank                      73 Bombay Mercantile Co-Op Bank           Audit
14    Hongkong & Shanghai               Ltd.                               Group II
      Bank                           74 Centurion Bank                     134 Financial, Treasury & Forex
15    Indian Bank                    75 The Saraswat Co-Op Bank Ltd.
16    Indian Overseas Bank                                                     Management
                                     76 Anyonya Sahayakari Mandali         135 Corporate Restructuring –Law & Practice
17    State Bank of India
                                        Co-Op Bank                         136 Banking & Insurance Law & Practice
18    State Bank of Indore
19    State Bank of Travancore       77 The Nainital Bank Ltd.             Group III
20    State Bank of Bikaner &        78 Purshottam Kanji Exchange Co.      137 WTO-International Trade, Joint Ventures
      Jaipur                            Ltd.                                   & Foreign Collaborations
21    State Bank of Patiala          79 The National Bank of Baharain      138 Direct & Indirect Taxes – Law & Practice
22    State Bank of Saurashtra       80 The Sakura Bank Ltd.               139 Human Resource Management &
23    Syndicate Bank                 81The Jammu & Kashmir Bank Ltd.           Industrial Relations
24    Punjab National Bank           82 Credit Agripole Indosuez
25    Vijaya Bank                    83 The Benares State Bank Ltd.
26    Standard Chartered Bank        84 American Express
27    Union Bank of India
                                     85 Ghaziabad Zila Sahakari Bank
28    Punjab & Sind Bank
29    Bank of Rajasthan
30    Vysya Bank                     86 The Bank of Nova Scotia
31    United Bank of India           87 The Sanwa Bank Ltd.
32    United Commercial Bank         88 Oman International Bank
33    ABN Amro Bank                  89 Development Credit Bank Ltd.
34    State Bank of Mysore           90 The Delhi Nagrik Sehkari Bank
35    Oriental Bank of               91 Jain Co-Op Bank Ltd.
     Commerce                        92 Society Generale
36    State Bank of Hyderabad        93 The Bank of Tokyo Mitsubishi
37    Central Bank of India             Ltd.
38    Karnataka Bank
                                     94 Oman Arab Bank S.A.O.C.
39    HDFC Bank
40    ICICI Bank                     95 Madhya Pradesh Rajya Sahakari
41   IDBI Bank                          Bank
42    UTI Bank                       96 Indore Swam Siddh Mahila Co-
43    Times Bank                        Op Bank
44    Deutsche Bank                  97 The Sarvodya Sahakari Bank Ltd.
45    Swan Bank                      98 The Vyavsayil Sahakari Bank Ltd.
46    Delhi State Cooperative Bank   99 Other Bank