IIRM INSTITUTE OF INSURANCE AND RISK MANAGEMENT

(Jointly set up by IRDAI and Government of Telangana)
Plot No. 38/39, Financial District, Nanakramguda, Gachibowli, Hyderabad-500 032
Ph No: +91 40 23000005, Fax: +91 40 23000254. Email: dlemail@iirmworld.org.in, Website: www.iirmworld.org.in

DISTANCE LEARNING
APPLICATION FOR ADMISSION INTO INTERNATIONAL POST GRADUATE DIPLOMA

Name of the Student Mr/Ms: *

Date of Birth: *

Upload Age Proof:

Gender: * Male Female

Email ID: *

Father Name: *

Communication Address: *

Permanent Address: *

City: *

State: *

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Zip/Pin: *

Land Line:

Mobile:

Course Applying for: *

IPGDI (Life) IPGDI (General) IPGDI (Risk Management)

Educational Qualification(s): *

Qualification(s)	Year of Passing	Board/University	Upload Marks Scan Copies	Aggregate Percentage

Note: Max File Size: 1000 kb, File Types are jpg, jpeg & pdf and one attachment is mandatory.

Work Experience (if any):

Company	From	To	Designation & Work Description

How did you come to know about IIRM:

Declaration of the Applicant*

I declare that the information furnished in this application is true to the best of my knowledge and I further expressly understand my admission is subject to satisfying the requirements of the IIRM and I shall abide by all the rules and regulations of the institute applicable from time to time.

To pay the registration fee of Rs 500/- online click here. Application without the fee are invalid

IIRM INSTITUTE OF INSURANCE AND RISK MANAGEMENT

DISTANCE LEARNINGAPPLICATION FOR ADMISSION INTO INTERNATIONAL POST GRADUATE DIPLOMA

Educational Qualification(s): *

Work Experience (if any):

DISTANCE LEARNING
APPLICATION FOR ADMISSION INTO INTERNATIONAL POST GRADUATE DIPLOMA