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    Form A Registration (Institutions)

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    col akhtar

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Form A Registration (Institutions)

    Uploaded by

    col akhtar
    9 views1 page

    Original Title

    form-a-registration-(institutions)-(1)

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    Copyright:

    © All Rights Reserved
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    9 views1 page

    Form A Registration (Institutions)

    Uploaded by

    col akhtar

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    GOVERNMENT OF PAKISTAN

    ALLIED HEALTH PROFESSIONALS COUNCIL


    Ex. PHRC Building, Shahra-e-Jamhuriat, Opp. Radio Pakistan,
    Sector G-5/2, Islamabad.
    Ph: (051)9216791; 9207367; 9207386 Ext. 20

    REGISTRATION FORM-A
    (ONLY FOR INSTITUTIONS)
    Name of Institution: ________________________________________________________________
    Postal Address: ____________________________________________________________________
    Tehsil________________ District: _________________ Province: ____________________________
    Number of Allied Health Disciplines offered by the Institute/university Administrative Control:
    Public/Private/ Semi Government/Trust/ Any other.
    Estimated number of students enrolled___________________________________________________
    Details of disciplines:
    1. 11. 21. 31.
    2. 12. 22. 32.
    3. 13. 23. 33.
    4. 14. 24. 34.
    5. 15. 25. 35.
    6. 16. 26. 36.
    7. 17. 27. 37.
    8. 18. 28. 38.
    9. 19. 29. 39.
    10. 20 30. 40.

    Date of Establishment: DD __________MM ________ YYYY____________


    Fee Details:
    Fee Deposit Slip No: _____________ Date: ______________ Amount (Rs.): ____________________
    (AHPC Registration Fee is non-refundable)

    Name of the Head of Institution/CEO/Owner: ___________________________________________

    Gender: Male Female CNIC: _______________________________________________


    Qualification: _______________________________________________________________________
    Email: ____________________ website: ___________________ Contact No(s):________________
    ________________________________
    Declaration: By signing below, I solemnly declare that the above provided information is true according to best of my knowledge
    and believe and there is nothing kept hidden from the authority.

    Institutional Seal/stamp:

    ______________________________
    Signature of the Head of Institution

    FOR OFFICE USE ONLY

    Decision: Approved Revision Required Not Approved

    Registration No. _____________________ Remarks (if any): _____________________________________

    Signature with Stamp

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