aims
IIMB

ONLINE REGISTRATION FORM
AIMS-IIMB Quality Improvement and Capacity Building Programme

APPLICATION ID

AIIMB_1550285596925

PROFILE OF THE FACULTY MEMBER

Name  
Designation  
Mobile No.  
Email
Service (in Years) (e.g. 1.5 or 12.11)
Teaching
Research
Any other
Total

PAYMENT DETAILS

Mode of Payment  
Amount paid: Rs. 17,700/- (Rupees Seventeen Thousand Seven Hundred only)
Payment Reference Number  
Date of Payment  

AUTHORIZATION

AIMS Membership No  
Select the Name of Institution  
Head of the Institution  
Email ID
(Only of the Head of the Institution)
Mobile  
(Only of the Head of the Institution)