Registration Form
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Use Mouse to move between fields for entry of data instead of using Tab Key. Fields marked with*are mandatory.


Read the instructions given below carefully, before filling the form:
  1. Candidate has to fill in the below mentioned details to receive the User Id and Password.
  2. Candidate will receive the User Id in the registered email address and Password as SMS on the registered mobile number.
  3. Candidate can login with the User Id and Password to complete the application for IPM 2017-22 batch.
  4. Candidate must provide correct Name, Date of Birth, Mobile Number and Email Address as these details cannot be changed once the registration is complete.
 
Step 1: Registration to get User Id and Password.
Note: Name should match as on Valid ID Proof and it should match with SSC / HSC / Diploma / Degree Certificate. List of Valid ID Proof is given in Registration Guide.
*Name of Candidate
Note: Candidate's name should be entered as per Standard X / SSC / equivalent examination certificate.
*Category
*Gender of Candidate
*Person with Disability/Differently Abled PWD(DA) Yes No
*Date of Birth
*Age as on 31.07.2017 Years   Months   Days
*Email Address
*Confirm Email Address
*Nationality
*Country of Residence
*Mobile Number
*Confirm Mobile Number
Note: Enter 10 digit Mobile no. for Country-India. For others enter Country code and Mobile no. of respective Country.

Please enter the letters displayed in the image below.
If the image is not clear, click on "Can't read the text? Get a new image"

Declaration
 

I hereby declare that I have carefully read the instructions. All particulars stated in this Registration Form are true and correct to the best of my knowledge and belief. If any information provided is false or incorrect, I shall abide by the actions and decisions taken by IIM Indore.

  I Agree
 
Version 12.03.00