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Journal of the Academy of Hospital Administration

Application for Membership of Academy of Hospital Administration

Author(s): editors

Vol. 12, No. 1 (2000-01 - 2000-06)

To

The President
Academy of hospital Administration,
CG-17, SFS Flats, Hauz Khas, New Delhi - 110016.

Dear Sir,

I wish to become the member of AHA, my particulars are as follows :

Name

Qualifications

Particulars of training in health/hospital administration

Professional experience

Address (residential) permanent

Present

_________________________________________________________________

Address (Office)

_________________________________________________________________

Telephone Office ________________________ Residence _______________________

Type of Membership applied for

Life Institutional Associate (Mark X)

Enclosed is cheque / draft no. ___________________________ Dated __________________

For Rs. ___________________________________________ Drawn on _____________________

Yours faithfully

Note
1. The cheque/draft to be made in the name of "Academy of Hospital administration".

2. A brief Bio-Data may please be attached.

3. Attach separate sheet if needed for qualifications and experience.

4. For outstation cheques please add. Rs. 35/-

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