REGISTRATION FORM FOR MANAGEMENT DEVELOPMENT PROGRAMS
MDP Cell,
Goa Institute of Management,
Poriem, Goa
Contact us:- mdpoffice@gim.ac.in ; 9834161149
www.gim.ac.in
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Select Programme
Name *
(Kindly note, the above mentioned name will be printed on the certificate)
Email *
Mobile Number *
Address
Your Company Name *
Designation
Department
Work Experience
Payment Details
Kindly make your programme payment to the following. Send us your UTR Number or Payment Reference ID after the completion of Payment.

Bank Account Number: 2361145OOOOO16
Beneficiary Name: Goa Institute of Management
Bank Name: HDFC Bank (Sanquelim Branch)
IFSC Code: HDFCOOO2361
Account Type: Savings Account
Payment Details (UTR No./Reference ID)
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