National Stock Exchange'S Certification In Financial Markets (Ncfm) Registration Form

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NATIONAL STOCK EXCHANGE'S CERTIFICATION IN FINANCIAL MARKETS (NCFM)
(ON-LINE Tests)
REGISTRATION FORM
(Please read instructions on page 4 carefully before filling up the form)
FIRST NAME
MIDDLE NAME
SURNAME
PART-I (In case you are already registered, please ignore Part I and fill-up Part II and III)
NAME TO BE PRINTED ON CERTIFICATE
Recent
Passport size
DATE OF BIRTH (DD-MMM-YYYY)
Colour Photograph
MALE/FEMALE
-
-
ADDRESS
FLAT NO/ H.NAME & NO.__________________________________________
STREET NAME : _________________________________________________
VILLAGE/AREA/DISTRICT : ________________________________________
LANDMARK : ____________________________________________________
(Candidates Signature- Sign inside the box)
STATE : ______________________________________________________
CITY
PINCODE
RESIDENCE/MOBILE NO: (WITH STD CODE)
OFFICE NUMBER (WITH STD CODE)
E MAIL - (MANDATORY)
QUALIFICATIONS
PROFILE
PERCENT /
YEAR OF
COURSE
UNIVERSITY / INSTITUTE
PASSING
GRADE
PART-II TEST DETAILS
NCFM-_____________________________ (specify registration number, if already registered under NCFM.)
MODULE NAME (Select the desired Module)
For Office Use only
AMFI-Mutual Fund (Advisors) Module
Capital Market (Dealers) Module
Hand Del/ Courier
AMFI-Mutual Fund (Basic) Module
Derivatives Market (Dealers) Module
Mails of the Day
Corporate Governance Module
Securities Market (Basic) Module
Chkd/Reg./Scanned
Compliance Officers (Brokers) Module
Surveillance in Stock Exchanges
Enrollment/DD Entry
Compliance Officers (Corporates) Module
FIMMDA-NSE Debt Market (Basic) Module
SM Issued/SM Sent
Information Security Auditors Module (Part-I)
Financial Markets: A Beginners' Module
Information Security Auditors Module (Part-II)
NSDL Depository Operations Module
Commodities Market Module
TEST SCHEDULE
TEST CENTRE
TEST DATE
TEST TIME
-
-
:
D D
M M M
Y
Y
Y Y
H H
M M
Once the test details has been specified by the candidate, the test cannot be rescheduled
Fees once paid shall not be refunded.
PART-III PAYMENT DETAILS
TOTAL DD AMOUNT
DD NUMBER 1
DD NUMBER 2
DD NUMBER 3
DD DATE ( DD-MM-YY)
-
-
ISSUING BANK (NAME AND BRANCH)
I certify that the above information provided by me is true and correct to the best of my knowledge, information and belief.
PLACE
DATE
-
-
2
0 0
(CANDIDATE'S SIGNATURE)

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