FIFACIES Application Form

PILLAI/FIFA/CIES EXECUTIVE PROGRAM 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(dd/mm/yyyy)

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



3. 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

Mobile Phone

E-mail

LinkedIn Account (http link)

Twitter Account (http link)



Part II - Additional Data Requirements For The University


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) ?



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

(A certified copy of identification document/passport must be attached to this application)

2. Educational background


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