APPLICATION FORM

Form No.

We Mean Business

I ncubation & D evelopment of E ntrepreneurial A bility with I nternational PGP

Please complete the form in BLOCK LETTERS

1. PERSONAL DETAILS
First Name Middle Name / Initial Last Name / Surname

Full Name:

Nationality:

Passport Number: Valid till: (DD/MM /YYYY):

Date of birth (DD/MM /YYYY): _ _ / _ _ / _ _ _ _ Gender: Male Parents name: Parents Profession: If parent has his / her own business, then indicate industry / sector / business area and business financial indicator (annual revenue / turnover etc.) Female
Please affix passportsize photograph

Permanent Address (These are the contact details we will use to communicate with you) Home Address:

City:

Pincode:

Country:

Email ID (essential for communication): Landline Telephone (including area code): Mobile Number: www.jgiidea.org

Mailing Address (If different from above) Mailing Address:

City:
Language Proficiency

Pin code:

Country:

List the Languages you know and rate as follows: 1Fluent, 2Moderate, 3Minimal Language Reading Writing Speaking

2. ACADEMIC CREDENTIALS/ EDUCATION:

Please list below, starting with the most recent, all qualifications achieved. Please provide information about the results you achieved. Also indicate whether you studied part time (PT), full time (FT) or distance learning (DL) and the qualification awarded (Bachelor, Masters, Postgraduate Diploma, etc). IMPORTANT: certified copies of certificates, degrees, and professional membership certificates will need to be attached as annexure to this application. If submitting application form online please scan the actual mark sheets and upload after filling the table below Date of Entry month/year Date of Graduation month/year FT/PT/DL Study University/ Institution / Country Qualification Obtained

% Obtained

Class/Grade

3. FULL TIME EMPLOYMENT HISTORY: (IF APPLICABLE)

Total number of years of full time work experience at start of program years months

Please complete this table starting with your current/latest employer. Additional information may be provided on a separate sheet as a table. www.jgiidea.org

EMPLOYMENT DETAILS (If not applicable, write N.A.): Please enclose an annexure stating your responsibilities for each position listed here.

No.

Name and address of the employer

Your positions

From

To

4. PLEASE LET US KNOW HOW YOU PLAN TO FINANCE YOUR PROGRAM:

IT IS POSSIBLE TO CHECK MORE THAN ONE BOX:
Private Funding Company Funding Bank Loan Other (Please specify)

Please indicate if you are currently a recipient of a scholarship or other funding

Yes

No

If yes, from which institution and for which purpose:

5. How did you hear of the JGI iDEA program? You may tick more than one if applicable.
Recommended by a Friend Relative Teacher Newspaper/Magazine (Please Specify): Other (Please Specify): Exhibition Seminar Internet

6. STATEMENT OF PURPOSE (Professional & personal reasons for wanting to participate and why you should be selected for the same)

7. HEALTH INFORMATION:
(This information is required since sports are an essential part of the program.) How do you rate your health overall? Please list any physical disability or aliments if applicable?

Are you under any medication on a continuous basis? Yes If Yes, Please specify: No

Are you suffering from any chronic illness? Yes If Yes, Please specify: No

Are you suffering from any allergies? Yes If Yes, Please specify: No

8. BRIEF WRITE UP ON BUSINESS IDEA (Optional)

9. ANNEXURES
Tick the Boxes as applicable 1. Certified photocopy of final year of the bachelor`s program.

2. Certificate of fitness from a registered medical practitioner. 3. Two references to be filled in the given reference letter format
This Application form should be completed in full and submitted with the above annexures. Incomplete forms are liable to be rejected

10. TERMS & CONDITIONS:

The JGIIDEA program is fully residential and will be conducted primarily in India in the Jain International Residential School (JIRS) campus. Students will be expected to be resident in the campus hostels for this program for a period of 18 (eighteen) months from the commencement of the program. The applicant shall fully abide by the admissions process and its criteria. If the application is rejected at any step of the admission process, the institution is not obliged to offer any explanation to the applicant. Students will be expected to travel and stay in international locations for specified periods of time as part of this program, and it will be their responsibility to prepare themselves for the same in all respects. The applicant agrees to attend all tutorials, classes, seminars and sports events on campus, as specified in the timetable which will be published shortly. Attendance will be part of the assessment of the student in each subject of the coursework. Disciplinary action will be taken against any applicant for any inappropriate form of behavior or conduct which can lead to exclusion/ termination from the program. Sexual harassment in any form will not be tolerated; this will be viewed extremely seriously and will certainly lead to disciplinary action including termination from the program. The applicant shall pay the first installment of the Program fees by cheque in favor of School of Leadership Excellence at the time of acceptance of the offer of selection. He / she shall pay the second and final installment of the same at the time specified by the institution. The Program Fees once paid will not be refunded under any circumstances.? The payment structure of the fees and broad schedule is as follows : For Indian nationals : Advance amount of Rs.50,000/ (Rupees fifty thousand only) within 7 days of receiving the letter of selection The first installment amount within 30 days of receiving the selection letter, or before the start date of the program, whichever is earlier The second installment amount, at the time specified by the institution in the second year of the program For International students : Advance amount of USD 1000/,within 7 days of receiving the letter of selection The schedule of payment of the installment amounts are similar to what has been described for Indian nationals above PAYMENT OF THE ADVANCE AND THE FIRST INSTALLMENT AMOUNTS ARE ESSENTIAL STEPS THAT THE STUDENT MUST FULFIL BEFORE THE START OF THE PROGRAM AS PER THE SCHEDULES DESCRIBED ABOVE All payments by cheque (Indian nationals only)need to be made in favour of 'School of Leadership Excellence" International students who wish to make payments from their home countries need to make the payments of the above mentioned amounts by wire transfer, for which the instructions and details will be communicated separately. PLEASE NOTE THAT NONE OF THE ABOVE FEES AMOUNTS ARE REFUNDABLE UNDER ANY CIRCUMSTANCES Upon selection, the applicant shall accept the offer of the same within one week of receiving the intimation of selection or else, he/she may risk forfeiture of the admission. The applicant agrees that he/she cannot withdraw from the course offered, without prior written permission from the Program Director and the CEO of JGI Ventures. The Program Director and/or the CEO of JGI Ventures have the right to refuse permission without assigning any reasons. The program fee includes all costs associated with tuition, boarding, lodging as well as international travel expenses, action learning and incubation.

All courses and modules in the program are subject to change and can vary from time to time. The Jain Group of Institutions (JGI) and the School of Leadership Excellence (SLE) reserve the right to change the contents of the course without any prior notice to the applicant / student. The applicant agrees to buy any recommended textbooks and any other material that may be required for all the study modules prior to the commencement of the program. The applicant shall possess valid passport (valid for at least 2 years) at the time of selection; if not, he / she is required to apply for the same immediately. The applicant, if selected for the program shall abide by all the rules, procedures, policies and guidelines that govern the institution during the program. These rules /procedures/ policies / guidelines may be amended from time to time. The student shall strive to uphold the values and philosophy of the institution at all times. The applicant should not have any criminal record in India or the country of origin (if he / she is a citizen of a country other than India). If the applicant is financing his / her participation in the program through a loan, then it is his/her sole responsibility to clear the same with the lending institution If the applicant is a citizen of a country other than India who is applying from his / her home country, it will be his / her responsibility to obtain the applicable visa and obtain the necessary legal clearances and permits from the Government of India. The institution (JGI), at the request of the applicant and on its discretion, may provide a letter of reference or evidence of selection to the program to facilitate the visa process. As the program has international travel and stay as part of the coursework, the selected student will need to sign a separate Agreement with the JGI before commencing the travel. The student who wishes to avail of the incubation facility for his / her business idea at the end of 18 months of the program shall enter into separate legal and business Agreements with JGI Ventures Ltd. at the appropriate time, as specified and directed by the CEO of JGI Ventures Ltd. or his designate. The student who decides not to avail of the incubation facility at the end of 18 months of coursework shall give a letter addressed to the CEO, JGI Ventures Ltd. indicating the same. By not availing the incubation facility, the student will not have the right to claim even partial refund of the Program fees.

11. APPLICANT'S DECLARATION:

I certify that the information given by me herein is complete and accurate to the best of my knowledge. I understand and accept that the application process fee and the program fees are nonrefundable under any circumstances I understand and accept that it is my responsibility to obtain the relevant documentation requested by JGI IDEA and authorize JGI or/and JGI Ventures, where necessary, to obtain further information from the appropriate educational institutions. I understand and accept that this information will be retained on a database for administrative and regulatory purposes. I understand and give consent to JGI or/and JGI Ventures to use my photo and name for news items, advertising, and publicity for JGI and its program as deemed necessary by the institution I understand and give consent to JGI or/and JGI Ventures to reserve the right to change any provision or requirement at any time, even within a student's term of enrolment, and that the institution further reserves the right to ask any student to withdraw from the program, for any due cause, at any time, without any refund of the program fees. I understand and give consent to JGI to publish any part or all of my submitted work for academic, external or internal purposes as required by the institution. I understand that JGI reserves the right to modify its fees, to add or withdraw members from its faculty or administration, and to arrange its courses, programmes, and facilities as teaching and economic exigencies render it desirable. I understand that admission to the JGI IDEA program is conditional upon my acceptance and compliance with the rules and regulations of JGI Ventures as now established or hereafter revised. I agree to abide by the rules and regulations of the JGI IDEA program, as well as the payment schedule for the Program fees. I have read and understood the 'terms and conditions' of the JGI IDEA program and I agree to abide by the same.

By signing I agree to (10. Terms & conditions) & (11. Applicant's declaration)

Date: _ _/_ _/_ _ _ _ Place: Applicant Signature

Please send your completed application form along with a DD of Rs. 1000/ payable at bangalore in favour of School for Leadership Excellence (with the envelope being marked as JGIiDEA APPLICATION 2011) along with annexure and other required documents to: Alternate payment method Online fund transfer / Cash Deposit Details:
A/C Name: School for Leadership Excellence Bank Name: Syndicate Bank A/C No: 04402010068050 Branch: V V Puram City: Bangalore IFSC Code: SYNB0000440

Please fill in your payment details here Payment Mode

DD Online Fund Transfer Cash Deposit

DD No. / Transaction ID: Bank: Branch: Dated:

Mailing address JGIiDEA JGI School of Leadership Excellence (SLE). First floor, 34, 1st cross, JC road, Bangalore560 027 | India Ph: +918043430171

*Please note: if you do a online fund transfer / cash deposit ( Acknowledgment scan copy)please mail the details to [email protected] with the transaction details

JGIiDEA: REFERENCE LETTER FORMAT

Name of referee : Occupation of referee : Name of Applicant: Note to referee: Before writing the reference for the applicant, please visit the website www.jgiidea.org to familiarize yourself with the program 1. How long have you known the applicant and in what capacity ?

2. What in your opinion, are the applicants strengths, with reference to his/ her aspiration of becoming an entrepreneur ?

3. What in your opinion, are the applicants weaknesses and development areas,with reference to his / her aspiration of becoming an entrepreneur ?

4.

Please rate the applicant on a scale of 1 to 5, (where 1 is lowand 5 is high) on the following parameters, with a comment on each : (Please circle as appropriate) a Initiative b Risktaking ability c Self motivation d Creativity and innovation e Decision making f Adaptation to change g Interpersonal skills h Communication I Time management skills 1 1 1 1 1 1 1 1 1 2 2 2 2 2 2 2 2 2 3 3 3 3 3 3 3 3 3 4 4 4 4 4 4 4 4 4 5 5 5 5 5 5 5 5 5

5. Is there anything else that you may want to add about the applicant with reference to his / her suitability to the JGIIDEA program that is not covered in the above?

Signature

JGIiDEA: REFERENCE LETTER FORMAT

Name of referee : Occupation of referee : Name of Applicant: Note to referee: Before writing the reference for the applicant, please visit the website www.jgiidea.org to familiarize yourself with the program 1. How long have you known the applicant and in what capacity ?

2. What in your opinion, are the applicants strengths, with reference to his/ her aspiration of becoming an entrepreneur ?

3. What in your opinion, are the applicants weaknesses and development areas,with reference to his / her aspiration of becoming an entrepreneur ?

4.

Please rate the applicant on a scale of 1 to 5, (where 1 is lowand 5 is high) on the following parameters, with a comment on each : (Please circle as appropriate) a Initiative b Risktaking ability c Self motivation d Creativity and innovation e Decision making f Adaptation to change g Interpersonal skills h Communication I Time management skills 1 1 1 1 1 1 1 1 1 2 2 2 2 2 2 2 2 2 3 3 3 3 3 3 3 3 3 4 4 4 4 4 4 4 4 4 5 5 5 5 5 5 5 5 5

5. Is there anything else that you may want to add about the applicant with reference to his / her suitability to the JGIIDEA program that is not covered in the above?

Signature