Application Form
P. D. Hinduja Hospital& Medical Research Center(Skill Development Center)
Affiliated By Maharashtra State Board of Skill Development (MSBSDE')
Form No. : 2022-23
Application Form for Full Time / Part TimeAllied Health Science program
(Form to be filled by Applicant in CAPITAL letter)
Course Type : Full time(FT) / Part Time(PT) (for working applicants with relevant exp.)
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Application form for provisional admission to the course in order of priority:
Address:
Details of Parents/Guardian:
Father
MOTHER/GUARDIAN
Educational Qualification Details:
School Details
Higher Educational Details
Degree Details
Other Certificates
Work Experience details:
ADMISSION PROCEDURE : Candidates should submit the following documents with duly filled application form | ||||||
3 passport size photographs | Experience Certificate if any | Aadhar card | ||||
Xth onwards all certificates and mark sheets (attested) | Cancelled cheque of your bank account | Pan Card/Voter Id | ||||
(For Office Use) Document Collected by | Verified by | |||||
FEES STRUCTURE: Fees can be paid in three instalments.Payment Details(DD/Cheque no.) | ||||||
Total Fees* (non- refundable) | `200 at the time of form submission `45000 + GST for six months courses `55000 + GST Tax for one year courses `78000 + GST Tax for two year courses | |||||
1st instalment : (at the time of admission + Post dated cheques for 2nd and 3rd installments) | On Admission `25000 + GST for six months courses `25000 + GST Tax for one year courses `40000 + GST Tax for two year courses | |||||
2nd instalment : (b/w1stSep. & 15thNov. after commencement of the course) | At the end of Ist month `20000 + GST Tax for six months courses `15000 + GST Tax for one year courses `20000 + GST Tax for two year courses | |||||
3rd instalment : (b/w1stSep. & 15thFeb. aftercommencement of the course) | At the end of 2nd month `15000 + GST Tax for one year courses `18000 + GST Tax for two year courses | |||||
Cheque / DD dishonoured by the bank will be charged at 500/ - per presentation, No candidate will be eligible to attend the course or the examination on non-payment of fees |