FIFACIES Application Form

PILLAI/FIFA/CIES EXECUTIVE PROGRAMME
IN SPORTS MANAGEMENT
Application Form

Part I - Data Requirements For Intranet Profile

1. Personal Information & Demographic Data

First Name*

Last Name*


E-mail*


Nationality n1*

Nationality n2


Country of Residence*

Mother Tongue*


Language Spoken n2*

Language Spoken n3


Gender*

Male Female

Date of Birth*

Do you play any sports?*

Yes No

If ‘yes’, please specify
Sport n1

Sport n2

Sport n3

2. Education

What is your highest qualification ? (PhD, Master, Bachelor, etc.)*

In which field of studies*

At which university / school / institution*

Is your highest qualification sport-related?*

Yes No

Besides your ‘highest qualification’, have you completed any sport-related education?*

Yes No

If ‘yes’, please specify
University/ School/ Institution

Diploma/ Degree obtained

Field of Studies

3. Professional Activity

Are you currently employed / working?*

Yes No

If ‘yes’, please specify
Your Job Position

Your Employer

Is your job sport-related - even partially/ indirectly?*

Yes No

If ‘yes’, please specify
Sport n1

Sport n2

Sport n3

If 'no', please specify
Your Field of Activity

4. Voluntary Activities (past or present)

Voluntary Activity (past or present)?*

Yes No

If ‘yes’, please specify
Your Voluntary Position

Your Voluntary Institution

Was/is your voluntary activity sport-related?*

Yes No

If ‘yes’, please specify
Sport n1

Sport n2

Sport n3

If 'no', please specify
The Field of Your Voluntary Activity

5. Contact Details & Social Networks

Country code

Mobile Phone*

E-mail

LinkedIn Account (http link)

Twitter Account (http link)


Part II - Additional data requirements for Pillai Institute

1. Personal Contact Information (capital letters)

Home Address*

Postal Code*

City*


Country*

Place of Birth*


Where did you hear about the course?*

Are you/were you a student at Mahatma Education Society (MES) ?*

Yes No

If ‘yes’, please provide your course details while you were at MES

2. Educational background

Please start with your highest qualification·*

Name of College/School Location Period of Study Field of Study

Professional qualification

Date Obtained Prof. Firm or Educ. Institution Qualification and Subject Result Obtained