ADMINISTRATIVE STAFF COLLEGE OF INDIA
POST GRADUATE IN MANAGEMENT (HOSPITAL MANAGEMENT)

(Approved by AICTE)

Instructions : Please use BLOCK letters to fill-in the application form. Please enclose Demand Draft or Online transaction for Rs. 1,000/- (Rupees One Thousand only) in favor of ‘Administrative Staff College of India’ payable at Hyderabad and share the transaction details to pgdhm@asci.org.in. Candidates are required to qualify in CAT*/CMAT/GMAT/MAT/XAT/ATMA/Other exams(as per AICTE). Shortlisted candidates will be notified of the dates and venue for Personal Interview.

Additional Contact Details
 
Education (Please enclose attested copies of the certificates / testimonials)
Particulars Qualification Name of Board / Institution/ University Year of Study From To Division /Percentage Attested Copy
SSC / CBSE / ICSE (10th)
Intermediate HSC / 12th
Graduation
Post Graduation/ Other (Specify)
Work Experience (If any)
If you do not have any work experience, just write "not applicable" in all fields in this section. Add More
Name of the Organization Designation / Job Description Reporting to Period From Period To
Details of Demand Draft attached

ASCI Fees can also be paid through DD or NEFT ( Online transfer). For paying by NEFT please refer to the bank details provided. If the payment is being made online, please mentioned the transaction id in place of "DD Number" in the above section and do mention "Online Transfer" along with the Bank Name in the "Drawn on Bank" field.

Bank Name : State Bank of India
Address : 6-3- 1092, Ist floor, A Block, Shanti Sikhara Complex, Somajiguda, 1st Floor, A Block, Bellavista Branch, Raj Bhavan Road, Hyderabad 500082
Beneficiary Account Name : Administrative Staff College of India
Savings Bank Account Number : 62090698675
Bank MICR Number : 500002306
NEFT IFSC Code : SBIN0020063

DECLARATION

I hereby declare and certify that the information furnished in this application form is true to the best of my knowledge. I have not been disqualified by any University from appearing for any examination or from seeking admission to any progrmme of study. If admitted, I agree to abide by the Rules and Regulations of ASCI.

Completed / Filled-in Application Form, Demand Draft, Certificates / Testimonials and Score Sheets duly attested by a Gazetted Officer should be sent to :

The Director
Centre for Healthcare Management
Administrative Staff College of India
College Park Campus, Road No. 3,
Banjara Hills, Hyderabad - 500 034.
Phone : 040-66720711, Fax : 040-66720725
E-maill : pgdhm@asci.org.in