Candidate Registration Form
All fields marked with
*
are mandatory.
Personal Information :
*
E-mail Address:
Note:
Certificates will be sent to this email address.
*
Confirm E-mail Address:
*
Password:
Note:
Password should be of minimum 6 and maximum 20 alphanumeric characters.
*
Confirm Password:
*
Title:
Select
Mr.
Ms.
*
First Name:
Middle Name:
Last Name:
*
Father Name:
Name to be printed on Certificate:
*
Date of Birth:
Clear
*
Gender:
Select
Male
Female
*
Permanent Account Number (PAN):
e.g.
ASWPD4468P
*
Confirm PAN:
*
Photo:
Browse Image
Click here to view Photograph Specifications
Note:
Photo size not to exceed 1 MB. Photo File name should contain alphabets, numbers, hyphen, spaces only.
Photo File name should NOT contain more than one fullstop i.e. ".".
Photograph Upload is mandatory prior to examination. You may not be permitted to appear for exam in absence of a proper photograph.
*
Scanned Image of PAN Card:
Browse PAN Image
Note:
PAN Scanned image size not to exceed 1 MB. PAN Scanned image File name should contain alphabets, numbers, hyphen, spaces only.
Aadhaar Number:
*
Proof of Address (PoA)
Select
*
Scanned Image of PoA:
Browse PoA Image
Note:
Proof of Address Scanned image size not to exceed 1 MB. Proof of Address Scanned Image File name should contain alphabets, numbers, hyphen, spaces only.
Passport Number:
Alternate Email Address:
Signature:
Contact Information :
*
Address Line 1:
Address Line 2:
Address Line 3:
*
City:
*
Pincode:
Search Pincode (India Only)
*
State:
-Select-
Andaman and Nicobar Islands
Andhra Pradesh
Arunachal Pradesh
Assam
Bihar
Chandigarh
Chhattisgarh
Dadra and Nagar Haveli
Daman and Diu
Goa
Gujarat
Haryana
Himachal Pradesh
Jammu & Kashmir
Jharkhand
Karnataka
Kerala
Ladakh
Lakshadweep
Madhya Pradesh
Maharashtra
Manipur
Meghalaya
Mizoram
Nagaland
New Delhi
Odisha
Puducherry
Punjab
Rajasthan
Sikkim
Tamil Nadu
Telangana
Tripura
Uttar Pradesh
Uttarakhand
West Bengal
*
*
Country:
-Select-
India
Please provide atleast one contact number for communication.
Tel. Residence:
ISD:
+
STD:
Phone:
Tel. Office:
ISD:
+
STD:
Phone:
*
Mobile Phone:
ISD:
+
Mobile:
Educational Qualification Details:
*
Educational Qualification:
Select
Below Higher Secondary
Higher Secondary/Diploma
Graduation
Post-Graduation
Below Higher Secondary:
Yes
No
Below Higher Secondary:
*
Class:
*
School/Board:
*
Year Of Passing:
*
Percentage/Grade:
Select
1
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4
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1900
1901
1902
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Higher Secondary/Diploma:
*
Major Subject:
*
Institute/University:
*
Year Of Passing:
*
Percentage/Grade:
Select
Arts
Science
Commerce
Diploma
Others
1900
1901
1902
1903
1904
1905
1906
1907
1908
1909
1910
1911
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2020
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2022
2023
Graduation:
*
Major Subject:
*
Institute/University:
*
Year Of Passing:
*
Percentage/Grade:
-- Select --
Arts
Science
Commerce
Engineering
Architecture
Law
Management
Medical
Diploma
1900
1901
1902
1903
1904
1905
1906
1907
1908
1909
1910
1911
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1914
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1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
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1995
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1997
1998
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2002
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2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
2023
-- Select --
Arts
Science
Commerce
Engineering
Architecture
Law
Management
Medical
Diploma
1900
1901
1902
1903
1904
1905
1906
1907
1908
1909
1910
1911
1912
1913
1914
1915
1916
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1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
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1991
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1998
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2006
2007
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2010
2011
2012
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2015
2016
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2019
2020
2021
2022
2023
Details of Post-Graduation
*
Major Subject:
*
Institute/University:
*
Year Of Passing:
*
Percentage/Grade:
-- Select --
Arts
Science
Commerce
Engineering
Architecture
Law
Management
Medical
Chartered Accountancy
Cost and Works Accountancy
Company Secretary
Others
Diploma
1900
1901
1902
1903
1904
1905
1906
1907
1908
1909
1910
1911
1912
1913
1914
1915
1916
1917
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1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
2023
-- Select --
Arts
Science
Commerce
Engineering
Architecture
Law
Management
Medical
Chartered Accountancy
Cost and Works Accountancy
Company Secretary
Others
Diploma
1900
1901
1902
1903
1904
1905
1906
1907
1908
1909
1910
1911
1912
1913
1914
1915
1916
1917
1918
1919
1920
1921
1922
1923
1924
1925
1926
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1928
1929
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1931
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1951
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1961
1962
1963
1964
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1966
1967
1968
1969
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1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
2023
-- Select --
Arts
Science
Commerce
Engineering
Architecture
Law
Management
Medical
Chartered Accountancy
Cost and Works Accountancy
Company Secretary
Others
Diploma
1900
1901
1902
1903
1904
1905
1906
1907
1908
1909
1910
1911
1912
1913
1914
1915
1916
1917
1918
1919
1920
1921
1922
1923
1924
1925
1926
1927
1928
1929
1930
1931
1932
1933
1934
1935
1936
1937
1938
1939
1940
1941
1942
1943
1944
1945
1946
1947
1948
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1950
1951
1952
1953
1954
1955
1956
1957
1958
1959
1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
2023
Professional Details:
Professional Qualification:
Institute/University:
Year Of Passing:
Percentage/Grade:
-- Select --
Chartered Accountant (CA)
Chartered Financial Analyst (CFA) from CFA Institute, USA
Cost Accountant (ICWA)
Certified Associate of Indian Institute of Bankers (CAIIB)
PhD./ M.Phil
Licentiate/Associate/ Fellowship of Life Insurance from Insurance Institute of India
Actuary from Institute of Actuaries of India
Civil Service Examinations by Union Public Service Commission (UPSC)
Company Secretary
Fellow, Financial Services Institute (FFSI) / Fellow, Life Management Institute (FLMI) from LOMA
Others
1900
1901
1902
1903
1904
1905
1906
1907
1908
1909
1910
1911
1912
1913
1914
1915
1916
1917
1918
1919
1920
1921
1922
1923
1924
1925
1926
1927
1928
1929
1930
1931
1932
1933
1934
1935
1936
1937
1938
1939
1940
1941
1942
1943
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1946
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1948
1949
1950
1951
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1958
1959
1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
2023
Occupational Details:
*
Occupation:
Select
Not employed
Employed
Self-Employed
*
Employed:
Yes
No
*
Total Experience (In years):
Select
*
Name of the Organization:
*
Designation:
*
From Date:
Clear
*
Address Line 1:
Address Line 2:
Address Line 3:
*
City:
*
State:
-Select-
*
Country:
-Select-
India
Others
*
*
Pincode:
Search Pincode (India Only)
*
Phone no.:
ISD:
+
STD:
Phone:
Fax no.:
ISD:
+
STD:
Fax:
Company Details:
SEBI Registration Number
Category
Please enter the verification code as it is shown in the image alongside.
I certify that all the above information provided by me is true to the best of my knowledge. I am aware that if any of the above information is found to be incorrect/incomplete NISM may take disciplinary action including withdrawal of certificate.
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