ADWIKA INSTITUTE OF NURSING

Applicant's Form * Mandatory fields

Select the Main Course *

Select the Sub Course *

How did you hear about us?

Name of the Applicant *

Mobile Number *

E-Mail *

Gender *

Male

Female

Date of Birth *

Permanent Address *

State *

City *

Pin Code *

Name of the Parent / Guardian *

Parent / Guardian Mobile Number *

Correspondence Address (If different form above)

Additional Info

Nationality*

Religion *

Community (SC/ST/BC/Others) *

Others

Whether the Candidate is NRI/Foreign National *

Yes

12th standard academic details

12th Standard Board Name *

12th Standard Register Number *

Marks obtained in Physics *

Marks obtained in Chemistry *

Marks obtained in *

Marks obtained in English *

Languages Studied

First Language *

Second Language *

Declaration by the Candidate:

I declare that the above information is correct and id admitted I promise to abide by the rules and regulations of the College.

Declaration by the Parent / Guardian:

I shall be responsible for my son's / daughter's / Ward's good behaviour and progress in the college if he/she granted admission. I also stand by the declaration given by my son / daughter to the college.

Note: Certified copies of SSLC & (PUC/Intermediate) Marks Card, Trasfer Certificate, Migration Certificate and Character Certificate from the Principal of the previous college to enclosed with this application at the time of admission (All Documents 2 Sets) with Latest 6 pasport/stamp size photos.