A. J. Institute of Hospital Management

(A Unit of Laxmi Memorial Education Trust ®)

A. J. Hospital & Research Centre Campus

Kuntikana, Mangalore - 575 004.

Application for Admission to

Master of Hospital Administration (MHA)

Part 1 - Personal Details



Part 2 - Academic Particulars

Exam Passed Name & Address of the School / College Name of the Board / University Class Obtained Percentage of Marks Year of Passing

Part 3 - Documents Required


Part 4 - Student Declaration

  • I agree to abide rule and regulations of the A. J. Institute of Hospital Management
  • I acknowledge that if I am accepted for a course of study I am liable to pay the fees for the full term and it will not be refunded under any circumstances.
  • I am aware that 75% attendance is mandatory in all subjects for a student to be eligible to appear for the university Examinations.
  • I am aware that consumption of alcohol and smoking is prohibited in the college and I agree to abide by this condition failing which necessary disciplinary action can be taken against me.
  • I hereby agree that I will not cause any damage to the college property; I accept that failure on my part to abide by this policy may lead to necessary disciplinary action and any related costs incurred by my actions will be recovered from me.
  • I am aware that delay in payment of the fees attracts a late fee (fine) until such time I have paid the same.
  • I agree that it is an essential term of my agreement with AJIHM that information I have given in this form and any attached documents is true and complete and I acknowledged that AJIHM may suspend my enrolment if false information has been given.

Please Return filled up application form to:
Admission Section
A. J. Institute of Hospital Management
A. J. Hospital & Research Centre Campus, NH-17, Kuntikana, Mangaluru - 575 004. D.K. Karnataka, India
Tel: 0824-6613246 Cell: 9964470708 E-Mail: