Affiliated to Kerala University of Health Sciences (KUHS)



B. Pharm Admission 2019 - 2020



Application Form


 
 Name
 Occupation
 Organization
 Annual Income
Father
Mother
      Male     Female
 Sl. No.
Course
Month & Year of Passing
 Board
School / College 
Number of Attempts 
Percentage of Marks
 1
 2
 3


 Sl. No.
 Subject
 Maximum Marks
 Marks Obtained
 Percentage
 1
 2
 3
 4
 5

JOINT UNDERTAKING BY THE APPLICANT AND PARENT/ GUARDIAN

1. The information furnished here is true and correct to the best of our knowledge. In case any information furnished is found incorrect, we agree to forgo any claim for admission and the student will forfeit the admission/seat at any stage of the course.

2. We promise to abide by all the rules and regulations of the college/ management.

3. We know that any amount paid to the institution is non refundable after admission. We undertake that we will not claim refund of the fee paid under any circumstances.

4. We agree that if the student wishes to leave the institution in the middle, we will pay the fee for the full course (all the 4 years) before the issue of the Transfer Certificate and other Certificates.




List of Enclosures (Xerox copies are to be attached with the application)

1. S.S.L.C

2. Plus Two Mark Sheet

3. Diploma Mark list

4. Transfer Certificate

5. Conduct Certificate

6. Passport size Photo 5 No.s

Note : Original certificate must be produced at the time of admission.