5. REGISTRATION FORM
INDIAN INSTITUTE OF CAPITAL MARKETS
Professional Development programme on
“INTEREST RATE RISK MANAGEMENT”
We nominate the following participant to attend the Program:
Name of the participant: ____________________________________________________________
Designation : _____________________________________________________________________
Organisation : _____________________________________________________________________
Address: __________________________________________________________________________
___________________________________________________ Pincode:________________________
Telephone:_________________________________ Fax No:_________________________________
Mobile No.: __________________________ Email: _______________________________________
Cheque/DD. No_____________ dated _______________ for R _________________ drawn on
___________________________ in favour of “Indian Institute of Capital Markets” is enclosed.
Signature & Stamp of the Nominating Authority: ___________________________________________
Programme Fees: R 21,000/-* (all inclusive) per participant on Non-residential basis
*The fees include participation’s course material, books (if any), lunch and tea/coffee.
Programme Dates: (Tick the appropriate Box) 
SN Dates Tick SN Dates Tick
1 July 5 -7, 2012 4 December 27 – 29, 2012
2 August 9- 11, 2012 5 February 21 – 23, 2013
3 October 18 – 20, 2012 6 April 11 – 13, 2013
Registration form alongwith Cheque /DD to be send at the following address:
Indian Institute of Capital Markets (UTI Institute of Capital Markets)
2nd Floor Hindavi Bhavan, Plot No. 13, Sector 1, Vashi, Navi Mumbai – 400 703
Tel No.: 022-2782 0114/15 Telefax: 022-2782 0153
Email: pdp@utiicm.com, info@utiicm.com
Website: www.utiicm.com
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