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*


Country of Residence*

Mother Tongue*


Language Spoken n2*


Gender*

Male Female

Date of Birth*

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

3. Professional Activity

Are you currently employed / working?*

Yes No

If ‘yes’, please specify
Your Job Position

Your Employer

4. Voluntary Activities (past or present)

Voluntary Activity (past or present)?*

Yes No

If ‘yes’, please specify
Your Voluntary Position

Your Voluntary Institution

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

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

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