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Management ADVANCED MANAGEMENT PROGRAMME

Development
Institute 24th Edition, 2019

NOMINATION FORM
Programme Duration: 4 weeks | Dates: August 19 - September 15, 2019 | 24th Edition
Please photocopy for multiple nominations How to Register for the Programme
1. REGISTRATION
Sponsoring Company Data Please complete this application form and mail or fax
to: The Chief Administrative Officer (Continuing
Company Name .................................................................... Education) Management Development Institute
Mehrauli Road, Sukhrali,
Mailing Address ...................................................................... Gurugram 122001 (Haryana) INDIA
Tel: +91-124-4560004 Fax: +91-124-4560005
City ..................................... PIN .......................................... E-mail: caomdp@mdi.ac.in
2. FEES AND TERMS OF PAYMENT
State ......................................................................................
The tuition fee is Rs. 2, 40,000/- for the Indian Phase-1
which includes boarding and lodging for 2 weeks at the MDI
E-mail ..................................................................................
campus. Additionally, Rs.3,10,000/- is payable towards the
Overseas Learning Programme (OLP). Phase- II this fee
Fax No. ................................................................................... includes the costs of academic inputs, travel to and fro &
within Europe in Economy Class airport transfers, medical
Type of Industry ......................................................................
insurance and visa charges. The tuition fee of Rs. 2,40,000/-
is payable with the nomination. The fee for the OLP is billed
Turnover (in Rupees Crore) .................................................. after acceptance and must be settled before the programme
begins. We accept payment through banks drafts and
Number of Employess ......................................................... NEFT/RTGS, payments should be made in favour of the
Management Development Institute, Gurugram. GST as
Please Enclose Latest Published Annual Report applicable will be charged extra (currently 18%)
Personal Data of the Nominee 3. NOMINATIONS AND CANCELLATIONS
The last date for receiving nominations along with the
Name ..................................................................................... Programme fee is 01st August, 2019. Nominations made
may be withdrawn or cancelled any time before the last date
Gender ...................... Age/Date of Birth ................................ at a nominal handling charge of Rs. 10,000. Thereafter, the
cancellation shall be subject to a charge of 50% of the fees.
Highest Degree Earned .......................................................... Substitutions are accepted.
4. OTHER EXPENSES
Years of Experience ............................................................... For the OLP, the per diem expenses for boarding end
lodging and any other personal expenses will have to be
Designation ..................... Mobile ........................................... met by the respective organizations according to their rules.
To facilitate logistics, arrangements for stay abroad and in-
Work Phones ......................................................................... city travel will be organized by MDI. Incidentals, telephone,
laundry, mail, etc. handled by MDI should be settled directly
E-mail address........................................................................ with us at the end of the programme.
5. CHANGE IN THE PROGRAMME
Fax Number ..................... Home Phone .............................
In the unlikely event of the programme being cancelled, all
sponsors and the participants will be promptly informed and
Mailing Address ......................................................................
a full refund provided.
Street/Location ....................................................................... Particulars of Payment enclosed:
Cheque/Draft no .................... dated..............................
City ....................................... PIN ........................................ drawn on ............................... (bank)...........................
for Rs.2,40,000/- in favour of Management Development
State ....................................... Institute, Gurugram.

Signature and name of the official making the nomination ............................................................................................................


Date ........................................... Designation of the official .......................................................
Email ......................................... Mobile .......................................

Management Development Institute, Mehrauli Road, Sukhrali, Gurugram 122001 (Haryana)


Fax No.: (+91-124) 4560005, EPABX: (+91-124) 4560000, Direct: (+91-124) 4560004, 4560008, 4560534,4560550
E-Mail : caomdp@mdi.ac.in, website : http://www.mdi.ac.in