National Institute of Management

Nomination Form (SMC)

NOMINATION FORM (21st SMC)

Annexure-A

(A) PROFFESSIONAL INFORMATION

Student Name*

Date of Birth*

CNIC*

Occupational Group/Cadre*

Gender* Male Female

marital status* Unmarried Married Widowed Divorced

Father Name*

Domicile*

Religion*

Designation*

Children

Office Address*

Present Address*

Residential Address*

Permanent Address

Contact Information

Office*

Fax No

Email*

Residence*

Mobile*

(B) WORK EXPERIENCE

Date of Joining Service (exact date) Present Gross Pay

Date of Appointment to the Pesent Job Dates of Promotion

Brief Description of Responsibilites of Present Post

Positions held since Promotion to BS-19 or equivalent, in Government or other organizations, showing dates and duration of each assignment held:

(Please specify month and year if dates not available)

Assignment held and grade Or equivalent	Ministry/Division/ Department/Organization	From	To

(C) ACADEMIC RECORD

Educational Qualifications (from Matriculation to date starting with the latest one) with disciplines and years:

Degree/Diploma	Subject	Institution	Year

(D) TRAINING RECORD

Training (s) Received

i) In Pakistan:

Name of Course	Duration of Each Course		Name of Institution
Name of Course	From	To	Name of Institution

ii) In Abroad:

Name of Course	Duration of each Course		Name of Institution	Country
Name of Course	From	To	Name of Institution	Country

Area of specialization :

Additional Technical or Professional Qualifications, if any

Membership of Official and Unofficial Committees/Commissions Name and designation of the Authority which maintains the PER of the nominee and to whom the report of the nominee to be sent

Membership of Academic/Literary/Professional Associations:

Published/Unpublished Work (Books, Articles, Reports)

Name of the Nominating Government Department/Organizations

Membership of Club’s in Pakistan:

Dated

Place

Annexure-B

HOSTEL ACCOMMODATION

I have been nominated for the 21st SMC which is commencing from Monday 6th March 2017. I am residing with my family

and during this 20 weeks course I shall avail Hostel Accommodation because I am not having any residential facility for self/family in Karachi and will abide the rules of NIM-Hostel

Please Select one Yes No

Please indicate the call name that you would like to be used on your NIM Identity Card e.g. Khan / Ahmed / Mansoor.

I have been nominated for the 21st SMC which is commencing from Monday 6th March 2017. It is requested that transport at Airport / Railway Station may please be made available.

Please find details of permanent disease/illness as under for record / information of a medical officer:

GYMNASIUM BILLIARD BADMINTON

TABLE TENNIS TENNIS (Hard Court) JOGGING

Note: Sports are “mandatory” for the participants of SMC at NIM Karachi.

Subject: Transport Parking at NIM, Karachi

As per policy, Car Stickers will be issued only to self driven cars. Concern participant may please write down the name & vehicle number.

NOMINATION FORM (21st SMC)

(A) PROFFESSIONAL INFORMATION

Contact Information

(B) WORK EXPERIENCE

(C) ACADEMIC RECORD

(D) TRAINING RECORD

HOSTEL ACCOMMODATION

CALL NAMES SLIP

REQUEST FOR TRANSPORT

Details

MEDICAL INFORMATION

SPORTS OPTION

NATIONAL INSTITUTE OF MANAGEMENT (NIM) KARACHI

21st Senior Management Course (SMC)

A. Proposed Topics of IRPs

B. Proposed Topics of CIPs

Subject: Transport Parking at NIM, Karachi

INSTRUCTIONS TO BE NOTED