1. SPECIAL FORM FOR PGP-ABM (2012-14)
Indian Institute of Management Post-Graduate Programme in
Lucknow Agri-Business Management
Instructions
1. This form is to be filled in by CAT applicants with academic background in non-
agricultural disciplines falling under eligibility criteria of PGP-ABM.
2. Please fill this form and bring at the time of GD/PI.
3. This form should be filled carefully by the candidate based on his/her own knowledge
and experience.
1. NAME ______________________________________________________________
2. Father’s Name ________________________________________________________
D D M M Y Y Y Y
3. Date of birth
4. CAT Registration Number1
5. Educational Background (Graduation onwords)
Degree/ Specialization Institute / University Year of Major Sunjects
Qualification Passing
Graduation
Post
Graduation
Any other
Any other
6. Exposure to rural areas: Years Months
1
See CAT Registration form for this.

2. Nature of exposure to rural areas2:
7. Work experience in agriculture and allied sector, If any Years Months
In case of work experience in agriculture and allied sector, please fill up the following table:
SNo. Name of Organization Type 3 Designation Nature of Job4 Experience in
months
1
2
3
4
5
8. Is/Are your parents’ occupation(s) anyway related to agriculture and allied sector?
Yes No
If yes, how _______________________________________________________________________
________________________________________________________________________________
9. Please provide reasons (in descending order of importance) for your motivation and interests
for applying to this specialized programme (PGP-ABM).
i.
ii.
iii.
iv.
v.
2
Specify whether it was your normal place of stay or you were there in connection with some duties /
responsibilities.
3
Organization: 01-Research; 02–Manufacturing; 03-Education; 04-Rural Development; 05-Agricultural Services;
06-Others (specify)
4
Nature of Job: 01-Marketing; 02-Finance;p 03-Production & Operation; 04-Human Resource; 05-Rural
Development; 06-Information Technology; 07-Academics; 08-Others (specify)

3. 10. What are your short term and long term career plans?
11. Name three companies/organizations where you would like to work after successful
completion of the PGP-ABM programme:
i.
ii.
iii.
12. How will you, as a PGP-ABM graduate, cater to the needs of the agri-sector and
contribute to its growth and development ? (enclose separate sheet, if needed)
13. Your publications related to agriculture and allied sector or rural development, if any
(enclose separate sheet, if needed) :
Title of Article Published in Year
Place:________________________ Signature:_____________________
Date: ________________________ Name:________________________
The Admission Office
Indian Institute of Management, Prabandh Nagar, Off Sitapur Road, Lucknow- 226 013
Phone : 0522 – 2736681/ 2736682 / 2734028 * Fax : 0522 – 2734025
* Email: admission@iiml.ac.in