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Get Corporate Compliance Executive Certificate

APPLICATION FOR CORPORATE COMPLIANCE EXECUTIVE CERTIFICATE Regulation 28 2 The Chief Executive The Institute of Company Secretaries of India ICSI House 22 Institutional Area Lodi Road New Delhi-110 003 Photo Self Attested Registration No. Name Mobile No. E-Mail Id Communication Address Intermediate / Executive Programme Passing Details Module/ Session Year Roll No. Group Self Attested Copy of mark I sheet is required to be II attached Final / Professional Programme III IV Training Details Name of Trainer Organisation / PCS Training Duration Completion Certificate is To required to be From Number of leaves availed Fee Details Bank Mode DD/Ack. Fee Amount Branch Date DD/Cash DECLARATION I hereby declare that the particulars furnished are true to the best of my knowledge and belief and if at any point of time it is proved that the said particulars were untrue I agree to my enrollment to the Corporate Compliance Executive Certificate be cancelled without any obligation on the part of the Institute to refund any fee paid by me to the Institute and without prejudice to the rights of the Institute to take any action in future as deems fit. I hereby undertake that I shall abide by such regulations bye-laws rules standing orders directions conditions or guidelines as laid down by the Council and made applicable to me from time to time. Fee Amount Branch Date DD/Cash DECLARATION I hereby declare that the particulars furnished are true to the best of my knowledge and belief and if at any point of time it is proved that the said particulars were untrue I agree to my enrollment to the Corporate Compliance Executive Certificate be cancelled without any obligation on the part of the Institute to refund any fee paid by me to the Institute and without prejudice to the rights of the Institute to take any action in future as deems fit. I hereby undertake that I shall abide by such regulations bye-laws rules standing orders directions conditions or guidelines as laid down by the Council and made applicable to me from time to time.

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