NATIONALSTOCKEXCHANGE'SCERTIFICATIONINFINANCIALMARKETS(NCFM)

REGISTRATIONFORM
(Pleasereadinstructionscarefullybeforefillinguptheform) FIRSTNAME LASTNAME MIDDLENAME

PARTIPERSONALDETAILS
NAMETOBEPRINTEDONCERTIFICATE (WILLBEPRINTEDSAMEAS'FIRSTNAMEMIDDLENAMELASTNAME') DATEOFBIRTH(DDMMMYYYY) ADDRESS FLATNO/H.NAME&NO. STREETNAME: VILLAGE/AREA/DISTRICT: LANDMARK: STATE:________________________________________________________ CITY OFFICENUMBER(WITHSTDCODE) PAN BelowHigherSecondary Yes HigherSec/TechnicalDiploma No
UNIVERSITY/INSTITUTE %/GRADE

MALE/FEMALE

Recent Passport size Colour Photograph

(CandidatesSignatureSigninsidethebox) RESIDENCE/MOBILENO:(WITHSTDCODE)

PINCODE(Mandatory) EMAIL(MANDATORY)

QUALIFICATIONDETAILS BELOWHIGHERSECONDARYONLY

Graduate

PostGraduate

HIGHERSECONDARY/TECHNICALDIPLOMA
MAJORSUBJECT YROFPASSING

GRADUATIONDETAILS
MAJORSUBJECT YROFPASSING UNIVERSITY/INSTITUTE %/GRADE

POSTGRADUATIONDETAILS
MAJORSUBJECT YROFPASSING UNIVERSITY/INSTITUTE %/GRADE

OCCUPATIONALDETAILS OCCUPATION Student SelfEmployed Service Others____________________(plsspecify)

IFEMPLOYED,KINDLYPROVIDECURRENTEMPLOYMENTDETAILS: NAMEOFTHEORGANISATION DESIGNATION FROMDATE(DDMMMYYYY) ADDRESSOFTHEORGANISATION

CITY

PINCODE

TELEPHONENO.(WITHSTDCODE)

FAXNO.(WITHSTDCODE)

NATIONALSTOCKEXCHANGE'SCERTIFICATIONINFINANCIALMARKETS(NCFM) (Pleasereadinstructionscarefullybeforefillinguptheform) Page2

PARTIITESTDETAILS
NCFM MODULENAME(TickthedesiredModule)
FinancialMarkets:ABeginners'Module English Gujarati Hindi ComplianceOfficers(Corporates)Module InformationSecurityAuditorsModule(PartI) InformationSecurityAuditorsModule(PartII) CommoditiesMarketModule NSDLDepositoryOperationsModule OptionsTradingStrategiesModule InvestmentAnalysisandPortfolioManagementModule CommercialBankinginIndia:ABeginner'sModule Hindi FundamentalAnalysisModule SecuritiesMarket(Advanced)Module Hindi BankingSectorModule InsuranceModule MacroeconomicsforFinancialMarketsModule FinancialModelingModule

(specifyregistrationnumber,ifalreadyregisteredunderNCFM.)

MutualFunds:ABeginners'Module CurrencyDerivatives:ABeginner'sModule EquityDerivatives:ABeginner'sModule InterestRateDerivatives:ABeginner'sModule SecuritiesMarket(Basic)Module CapitalMarket(Dealers)Module English Gujarati

ForOfficeUseonly HandDel/Courier MailsoftheDay Chkd/Reg./Scanned Enrollment/DDEntry SMIssued/SMSent

DerivativesMarket(Dealers)Module English Gujarati

FIMMDANSEDebtMarket(Basic)Module SurveillanceinStockExchangesModule CorporateGovernanceModule ComplianceOfficers(Brokers)Module

Note: TestinCapitalMarket(Dealers)Module,DerivativesMarket(Dealers)Module,FinancialMarkets:ABeginners'Module areavailableinEnglish,GujaratiandHindilanguages.Pleaseticktheappropriatelanguage. PREFERREDTESTCENTRE (mandatory)

TESTSCHEDULE
TESTCENTRE TESTDATE Y Y Y TESTTIME : H H M M D D M M M Y Oncethetestdetailshasbeenspecifiedbythecandidate,thetestcannotberescheduled Feesoncepaidshallnotberefunded.Testfeesarevalidfor180daysfromthedateofpayment. Candidatesneedtoenrollforthetest(s)within180daysfrompaymentoffees.

PARTIIIPAYMENTDETAILS
DDNUMBER1 DDNUMBER2 DDNUMBER3 DDDATE(DDMMYY) TOTALDDAMOUNT

ISSUINGBANK(NAMEANDBRANCH) Icertifythattheaboveinformationprovidedbymeistrueandcorrecttothebestofmyknowledge,informationandbelief. PLACE DATE 2 0 (CANDIDATE'SSIGNATURE)

INSTRUCTIONSFORFILLINGUPREGISTRATIONFORM
1 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 FirstName,MiddleName,LastNameandDateofBirthmandatorily.FillinyourDATEOFBIRTHinthefollowingformat:DDMMMYYYY(e.g.23MAR1974) NametobePrintedonCertificatewillbeprintedsameas'FirstNameMiddleNameLastName'. 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 providedforsignature. Pleasementionfullcontactdetailswithcity,pincode&state.Pleasespecifyyourtelephoneno./mobileno.andemail. Pleasefillinthequalificationandoccupationdetailsasmaybeapplicable. Fees to be paid by Demand Draft in favour of 'National Stock Exchange of India Limited, payable at the nearest NSE office. Also keep a photocopy of the demand draft with you,beforeyousendittoNSE.Pleasewritethenameofthecandidateonthereverseofthedemanddraft. Fees:(seeModuletablegiveninnextsheet)Pleasenotethattestfeesoncepaidarenonrefundable. Scorecard: Scorecard is issued on the spot to the candidate after the completion of test (only if photograph is uploaded). This service is free of charge. For subsequent requestsforscorecardademanddraftofRs.50/ispayable. Onlineregistrationisalsopossibleonwww.nseindia.com.Pleasevisitthewebsiteforcompletedetails. Pleaseticktheboxofthemoduleyouwishtoappear.ThedetailsofNCFMmodulesaregiveninthenextsheet Feesoncepaidshallnotberefunded.Testfeesarevalidfor180daysfromthedateofpayment.Candidatesneedtoenrollforthetest(s)within180daysfrompayment offees.Alsoonceenrolled,testscannotberescheduled/postponed. Atthetimeofthetest,ifitisseenthatthephotographhasnotbeenuploaded,thenyouwouldbeallowedtotakethetestonlyonfurnishingapassportsizephotographand anattestedcopyofaphotoidproof(attestationbyGazettedOfficer).Theoriginalphotoidproofwouldberequiredtobeshownatthetimeoftheexamination. In the space provided for TEST DETAILS (PartII), 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 email or fax. Please refer the format given on the website under offline registration procedure. The list of the candidates who have beenenrolledwillbedisplayedonthesite. The study material of all modules (except for Corporate Governance, Compliance Officers Modules & Financial Modeling Module) will be sent to you by courier in SEVEN working days from date of payment. Please mark your envelopes as 'To NCFM Department'. Please note that study material will NOT be provided in case of balance payment beingmade. Forms can be sent by courier / post to any of the NSEIL offices. Form submission by hand delivery at all NSEIL offices is on MonFri between 10:00 am to 5:00 pm only. (In case of Ahmedabad it is between 10:00 am to 4:00 pm). In case of Mumbai office, the duly filled up form with requisite payment can also be put in a dropbox kept at the mainentranceattheBandraKurlaoffice. 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 Park, 1st Floor, Near G. E. Garden, LBS Marg, Kanjurmarg (West), Mumbai 400078 office for this training material. Tel No: 022 66406789 Study Material for the Corporate Governance module is available for sale at ICSI offices at: A) ICSICentre for Corporate Research & Training, Plot No. 101, Sector 15, Institutional Area, CBD Belapur, Navi Mumbai400614 #02227577814 16 Extn. 406, email: ccrt@icsi.edu, ccrt@vsnl.com B) Western Indian Regional Council (WIRC) of the ICSI,13JollyMakersChambersII,FirstFloor,NarimanPoint,Mumbai400021,TelNo:02222047569,ContactPerson:Mr.Mani,email:wiro@icsi.edu IncaseofComplianceOfficersModules,candidatesarerequiredtorefertotherelevantbooks,circulars,manualsetc.,asperthegivencurriculum,ontheirown.Nostudy materialwillbeprovidedfortheComplianceOfficersModules. Please note that the NCFM tests are conducted at the mentioned test centers from Monday to Friday only (at Mumbai on Sat also). The NCFM registration forms can be senttothefollowingNSEoffices: TimeSlots(in hours) NationalStockExchangeofIndiaLtd.,ExchangePlaza,BandraKurlaComplex, NationalStockExchangeofIndiaLtd.,UnitedIndiaBuilding,2ndFloor,Near 9:30,11:30, Bandra(East),Mumbai400051Tel:(022)26598216,Fax:(022)26598393E KashmirEmporium,Opp.ApnaBazaar,SirPhirozeshahMehtaRoad,Fort, 13:30,15:30 Mumbai400001(LandmarkAboveIndianBank) mail:ncfm@nse.co.in NSEOffice TestCenter NationalStockExchangeofIndiaLtd.,4thFloor,JeevanViharBuilding, 9:45,11:45, NationalStockExchangeofIndiaLtd.,4thFloor,JeevanViharBuilding, ParliamentStreet,NewDelhi110001(LandmarkNearPatelChowk,Metro ParliamentStreet,NewDelhi110001(LandmarkNearPatelChowk, 13:45,15:45 Station)Tel.:(011)2334431327Fax:(011)23366658email: MetroStation)Tel.:(011)2334431327Fax:(011)23366658email: ncfm_delhi@nse.co.in ncfm_delhi@nse.co.in NSEiTTestCenter,KaveriComplex(GroundFloor),No.96104, NationalStockExchangeofIndiaLtd.,2ndFloor,IspahaniCentre,DoorNo. Asper NungambakkamHighRoad,Opp.SterlingRoadBusStop,Nungambakkam, 123124,NungambakkamHighRoad,Nungambakkam,Chennai6000034 availability (LandmarkNexttoIncomeTaxOffice/CAInstitute)Tel.:(044)28332500/01; Chennai600034 28332511;Fax:(044)28332521;email:ncfm_chennai@nse.co.in NationalStockExchangeofIndiaLtd.,406,SakarII,NearEllisBridge, NSEiTTestCenter,401,SapphireComplex,4thFloor,OppTimesSquare, Ahmedabad380006(LandmarkOpp.TownHall,NearEllisbridge)Tel.: NearBodylineCharRasta,C.G.Road,Ahmedabad380019(LandmarkNear (079)26580212/3Fax:(079)26576123.email:ncfm_ahmedabad@nse.co.in BodylineCharRasta,C.G.Road)

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NationalStockExchangeofIndiaLtd.,1stFloor,ParkViewApartments,99, NSEiTTestCenter,54/1/A,1stFloor,NavJeevanApartments,HazraRoad, Asper RashBehariAvenue,Kolkata700029(LandmarkDeshpriyaPark,NearPriya Kolkata700019(LandmarkOpp.HazraLawCollege/HDFCBank availability Cinema,AboveGKBOpticals).Tel.(033)24631802/40400400Fax.(033) Building) 40400440;email:ncfm_kolkata@nse.co.in NSEiTTestCenter,303304,3rdFloor,MahavirChambers,36363,Near NationalStockExchangeofIndiaLtd.,HNo.36322,MahavirHouse,IInd Floor,Chamberno.203&204,Basheerbagh,Hyderabad500029(Landmark LibertyCrossRoad,Basheerbagh,Hyderabad500029 NearPoliceCommissioner'sOffice,BasheerbaghSquare)Tel:(040) 23227084/5Fax:(040)23227086.email:ncfm_hyderabad@nse.co.in Asper availability

Anyothercentre(dependingondemand)visitourwebsite:nseindia.com>ncfm>testing>testatotherlocations

LISTOFMODULES Sr.No. NAMEOFMODULE 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 FinancialMarkets:ABeginners'Module* MutualFunds:ABeginners'Module CurrencyDerivatives:ABeginner'sModule EquityDerivatives:ABeginner'sModule InterestRateDerivatives:ABeginner'sModule CommercialBankinginIndia:ABeginner'sModule SecuritiesMarket(Basic)Module CapitalMarket(Dealers)Module* DerivativesMarket(Dealers)Module* FIMMDANSEDebtMarket(Basic)Module InvestmentAnalysisandPortfolioManagementModule FundamentalAnalysisModule SecuritiesMarket(Advanced)Module BankingSectorModule InsuranceModule MacroeconomicsforFinancialMarketsModule NSDLDepositoryOperationsModule CommoditiesMarketModule SurveillanceinStockExchangesModule CorporateGovernanceModule ComplianceOfficers(Brokers)Module ComplianceOfficers(Corporates)Module InformationSecurityAuditorsModule(PartI) InformationSecurityAuditorsModule(PartII) OptionsTradingStrategiesModule FPSBIndiaExam1to4*** Examination5/AdvancedFinancialPlanning*** EquityResearchModule## IssueManagementModule## MarketRiskModule## FinancialModelingModule### Duration No.of (inmins) Questions 120 120 120 120 120 120 105 105 120 120 120 120 120 120 120 120 75 120 120 90 120 120 120 120 120 120 240 120 120 120 150 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 60 50 100 60 60 90 90 60 75 30 65 80 50 50 MaxMarks 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 140 100 100 100 100 75 Certificate Pass Marks Validity (in Fees(Rs.) (%) yrs) 50 5 1500 50 5 1500 50 5 1500 50 5 1500 50 5 1500 50 60 50 60 60 60 60 60 60 60 60 60# 50 60 60 60 60 60 60 60 60 50 55 55 55 50 5 5 5 3 5 5 5 5 5 5 5 5 3 5 5 5 5 2 5 NA NA 2 2 2 NA 1500 1500 1500 1500 1500 1500 1500 1500 1500 1500 1500 1500 1800 1500 1500 1500 1500 2250 2250 1500 2000per exam 5000 1500 1500 1500 1000

*CandidateshavetheoptiontotakethetestinEnglish,GujaratiandHindilanguages. ***FollowingarethemodulesofFinancialPlanningStandardsBoardIndia(CertifiedFinancialPlannerCertification): FPSBIndiaExam1to4i.e.(i)RiskAnalysis&InsurancePlanning(ii)RetirementPlanning&EmployeeBenefits(iii)InvestmentPlanningand(iv)Tax Planning&EstatePlanning Examination5/AdvancedFinancialPlanning #Candidatessecuring80%ormoremarksinNSDLDepositoryOperationsModuleONLYwillbecertifiedasTrainers. ##ModulesofFinitiativesLearningIndiaPvt.Ltd.(FLIP) ###ModuleofIMSProschool