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REGISTRATION FORM
(Please read instructions carefully before filling up the form)
FIRST NAME MIDDLE NAME
LAST NAME
PAN
QUALIFICATION DETAILS Below Higher Secondary Higher Sec / Technical Diploma Graduate Post Graduate
GRADUATION DETAILS
MAJOR SUBJECT YR OF PASSING UNIVERSITY / INSTITUTE % / GRADE
POST-GRADUATION DETAILS
MAJOR SUBJECT YR OF PASSING UNIVERSITY / INSTITUTE % / GRADE
OCCUPATIONAL DETAILS
Currency Derivatives: A Beginner's Module Commodities Market Module For Office Use only
Equity Derivatives: A Beginner's Module Surveillance in Stock Exchanges Module Hand Del/ Courier
Interest Rate Derivatives: A Beginner's Module Technical Analysis Module Mails of the Day
Commercial Banking in India: A Beginner's Module Mergers and Acquisitions Module Chkd/Reg./Scanned
FIMMDA-NSE Academy Debt Market (Basic) Module Back Office Operations Module Enrollment/DD Entry
Securities Market (Basic) Module Wealth Management Module SM Issued/SM Sent
Clearing Settlement and Risk Management Module Project Finance Module
Investment Analysis and Portfolio Management Module Mutual Funds (Advanced) Module
* NISM has specified the NISM-Series-VIII-Equity Derivatives Certification Examination as the requisite standard for associated persons
functioning as approved users and sales personnel of the trading member of an equity derivatives exchange or equity derivative segment
of a recognized stock exchange.
TEST SCHEDULE
TEST CENTRE TEST DATE TEST TIME
- - :
D D M M M Y Y Y Y H H M M
Once the test details has been specified by the candidate, the test cannot be rescheduled
Fees once paid shall not be refunded. With effect from July 1, 2018 the validity of the NCFM test fees is revised from 180 days to 90 days from
the date of receipt of payment. Candidates need to enroll for the test(s) within 90 days from the date of receipt of payment of fees.
PART-III PAYMENT DETAILS
I certify that the above information provided by me is true and correct to the best of my knowledge, information and belief.
PLACE
DATE - - 2 0
(CANDIDATE'S SIGNATURE)
NSE ACADEMY'S CERTIFICATION IN FINANCIAL MARKETS (NCFM)
(Please read instructions carefully before filling up the form)
Page 3
PART-III (How DID YOU COME TO KNOW ABOUT THE NCFM PROGRAM) MANDATORY
HOW DID YOU COME TO KNOW ABOUT THE NCFM PROGRAM (Tick the source and mention the details)
Visit to NSE
Name of the college / institution _____________________________________
Location ____________
Date __________
NSE's website
Please fill in all details in the entire form only in BLOCK LETTERS. Write only one alphabet in each square provided. Leave one square blank between words. Please fill in the First Name, Middle Name, Last Name
1 and Date of Birth mandatorily. Fill in your DATE OF BIRTH in the following format :- DD-MMM-YYYY (e.g. 23 MAR 1974)
2 Name to be Printed on Certificate will be printed same as 'First Name Middle Name Last Name'.
3 You are required to paste a recent colour passport size photograph in the space provided. Do not staple the photograph. Do not sign across the photograph. Sign in the block provided for signature.
4 Please mention full contact details with city, pincode & state. Please specify your telephone no./mobile no. and email.
Fees to be paid by Demand Draft in favour of 'NSE Academy Limited’, payable at the nearest NSE office. Also keep a photocopy of the demand draft with you, before you send it to NSE Academy. Please write the
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name of the candidate on the reverse of the demand draft.
7 Fees : (see Module table given in next sheet). Module fees are inclusive of service tax. Please note that test fees once paid are non-refundable.
8 On-line registration is also possible on www.nseindia.com. Please visit the website for complete details.
9 Please tick the box of the module you wish to appear. The details of NCFM modules are given in the next sheet
10 Fees once paid shall not be refunded. With effect from July 1, 2018 the validity of the NCFM test fees is revised from 180 days to 90 days from the date of receipt of payment. Candidates need to enroll for the
test(s) within 90 days from the date of receipt of payment of fees. Also once enrolled, tests cannot be rescheduled / postponed.
11 The original photo id proof would be required to be shown at the time of the examination.
In the space provided for TEST DETAILS (Part-II), Please mention Test Center. Test date and time may be submitted as per your choice and as per the availability at each test center. Test date can be informed by e-
12 mail or fax. Please refer the format given on the website under off-line registration procedure. The list of the candidates who have been enrolled will be displayed on the site.
13 In the space provided for HOW DID YOU COME TO KNOW ABOUT THE NCFM PROGRAM (Part-III), please tick the source and mention the corresponding details.
Forms can be sent by courier / post to any of the NSEIL offices. Form submission by hand delivery at all NSEIL offices is on Mon-Fri between 10:00 am to 5:00 pm only. (In case of Ahmedabad it is between 10:00 am
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to 4:00 pm). In case of Mumbai office, the duly filled up form with requisite payment can also be put in a drop-box kept at the main entrance at the Bandra-Kurla office.
NCDEX distributes the training material of Commodities Market Module free of cost only to their active members and to others at a cost of Rs. 500/- plus courier charges. Kindly contact NCDEX, Akruti Corporate
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Park, 1st Floor, Near G. E. Garden, LBS Marg, Kanjurmarg (West), Mumbai - 400078 office for this training material. Tel No: 022-66406789
Please note that the NCFM tests are conducted at the mentioned test centers from Monday to Friday only (at Mumbai - on Sat depend upon the availability). The NCFM registration forms can be sent to the
16 following NSE offices:
1 NSE Academy C/O:National Stock Exchange of India Ltd.Exchange Plaza, Bandra-Kurla Complex, Bandra (East), NSEIT Limited – Mumbai, Trade Globe, Ground Floor, Andheri-Kurla Road, 9:30, 11:30,
Mumbai 400051 Toll Free Number : 1800 22 0051 Fax: (022) 26598393, Email : ncfm@nse.co.in For certificate Opposite Hotel VITS / Apna Dhaba, Behind Trade Star, Andheri (E), Mumbai- 13:30, 15:30
related queries: ncfmcert@nse.co.in For test center related queries : ncfmta@nse.co.in 400 059
2 National Stock Exchange of India Ltd. 4th Floor, Jeevan Vihar Building, Parliament Street, New Delhi-110001 NSEiT Limited- Delhi test centre, Jhandewalan Extension, Landmark: 9:30, 11:30,
(Landmark - Near Patel Chowk, Metro Station), Tel : 011-49393000/50, Fax : 011-23366658, Email : Jhandewalan Metro Station, New Delhi – 110055 13:30, 15:30
ncfm_delhi@nse.co.in
3 National Stock Exchange of India Ltd. 8th Floor, Arihant Nitco Park, No 90, Dr Radhakrishnan Salai, Mylapore, NSEiT- Chennai Test Center, Kaveri Complex (Ground Floor), No.96-104, 9:30, 11:30,
Chennai 600 004 Tel No : (044) 28479900 / 28479902-05, Fax No : (044) 28479926/27, Email : Nungambakkam High Road, Opp. Sterling Road Bus Stop, Nungambakkam, 13:30, 15:30
ncfm_chennai@nse.co.in Chennai – 600 034
4 National Stock Exchange of India Ltd, 304 &305 GCP Business Center, Opp Memnagar Fire Station, Navrangpur, NSE.IT Limited Ahmedabad Test Center, 302, Sutaria Complex, 3rd Floor, 23, 9:30, 11:30,
Ahmedabad -380009 Ph - :079-49008604, Fax :- 079- 49008660, Email : ncfm_ahmedabad@nse.co.in Maharashtra Society, Lane Between Medisurge Hospital (HCG) and Reliance 13:30, 15:30
Fresh, Near Mithakhali Six Road, Lions Club Road, Ellibridge, Ahmedabad-
380006
5 National Stock Exchange of India Ltd. 1st Floor, Park View Apartments, 99, Rash Behari Avenue, Kolkata – 700 029 NSEiT - Kolkata Test Center, 54/1/A 1st Floor, Nav-Jeevan Apartments, Hazra 9:30, 11:30,
(Landmark - Deshpriya Park, Near Priya Cinema, Above GKB Opticals), Tel : (033) 24631802/40 400 400, Fax. (033) Road, Kolkata – 700019 Landmark: Opp. Hazra Law College / HDFC Bank 13:30, 15:30
40400440, Email : ncfm_kolkata@nse.co.in Building
6 National Stock Exchange of India Ltd. 8-2-594/A/1, Third Floor,Urmila Heights, Opp Rainbow Hospital, Chamber NSEiT Limited, 403, 4th Floor, Moguls Court, 5-9-60, Basheerbag, 9:30, 11:30,
no.203 & 204, Road No 10, Banjara Hills, Hyderabad – 500034, Ph No: 040-23357082/ 7083, Fax No: 040-23357084, Hyderabad – 500001 Andhra Pradesh Landmark - Above Tribhovandas 13:30, 15:30
Email : ncfm_hyderabad@nse.co.in Bhimji Zaveri / Next to LB Stadium / Adjacent to Babukhan Estates
7 Any other centre (depending on demand) visit our website: nseindia.com > education> prepare for testing > test centres > tests at other locations
NCFM Test Details