Application Form

Choose Your Institutions

College Name*-- Choose College --College of NursingCollege of Pharmaceutical Sciences

Name*

Father's Name*

Mother's Name*

Date of Birth*

Age*

Gender*MaleFemale

Select A Religion* -- Choose your Religion --HinduChristianMuslimOther

Please Specify Your Religion*

Community*

Whether He / She is a first graduate?*YesNo

Address*

Contact No*

Email If any*

How Do You Know About Our College* -- Choose your Source--a) Newspaper Advertisementsb) Television advertisementsc) Google / Whatsapp / Instagram/ Linkedind) Texcity Alumnie) Schoolf) Others

Please Specify How Do You Know About Our College*

Course Preferred* -- Choose your Course --B.SC,DGNM,M.Sc,

Month & Year of passing higher secondary examination*

Higher Secondary Group*

Marks obtained in the individual subject in HSC*

Total Percentage in Phy, Che, Bio, English*

Month & Year of passing higher secondary examination*

Higher Secondary Group*

Marks obtained in the individual subject in HSC*

Name of the U.G Degree*

Month & Year of Passing*

Name of the University*

Date of RN.RM Registration*

Years of Experience after U.G Degree*

Course Name*-- Choose your Course --D.Pharm

Month & Year of passing higher secondary examination*

Higher Secondary Group*

Marks obtained in the individual subject in HSC*