Scribd Logo
Upload

Welcome to Scribd!

  • 4 views

    Pharmacy Application Form 2022 - 1

    Uploaded by

    Reubena
    This document is an application form for admission to the Diploma in Pharmacy program at Laithangpuii College of Pharmacy for the 2022-2024 session. The form requests basic personal information from the applicant such as name, date of birth, address, qualifications. It also requires documents like birth certificate, academic certificates, ID proofs to be submitted. The applicant and parent/guardian must declare that they have read the college prospectus, will abide by the rules, and are liable for any incorrect information provided. The parent also undertakes to bear responsibility for the applicant's conduct and pay fees on time.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content

    You might also like

    Pharmacy Application Form 2022 - 1

    Uploaded by

    Reubena
    4 views2 pages
    This document is an application form for admission to the Diploma in Pharmacy program at Laithangpuii College of Pharmacy for the 2022-2024 session. The form requests basic personal information from the applicant such as name, date of birth, address, qualifications. It also requires documents like birth certificate, academic certificates, ID proofs to be submitted. The applicant and parent/guardian must declare that they have read the college prospectus, will abide by the rules, and are liable for any incorrect information provided. The parent also undertakes to bear responsibility for the applicant's conduct and pay fees on time.

    Original Description:

    hi

    Original Title

    PHARMACY APPLICATION FORM 2022_1

    Copyright

    © © All Rights Reserved

    Available Formats

    PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    Report this Document
    This document is an application form for admission to the Diploma in Pharmacy program at Laithangpuii College of Pharmacy for the 2022-2024 session. The form requests basic personal information from the applicant such as name, date of birth, address, qualifications. It also requires documents like birth certificate, academic certificates, ID proofs to be submitted. The applicant and parent/guardian must declare that they have read the college prospectus, will abide by the rules, and are liable for any incorrect information provided. The parent also undertakes to bear responsibility for the applicant's conduct and pay fees on time.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    4 views2 pages

    Pharmacy Application Form 2022 - 1

    Uploaded by

    Reubena
    This document is an application form for admission to the Diploma in Pharmacy program at Laithangpuii College of Pharmacy for the 2022-2024 session. The form requests basic personal information from the applicant such as name, date of birth, address, qualifications. It also requires documents like birth certificate, academic certificates, ID proofs to be submitted. The applicant and parent/guardian must declare that they have read the college prospectus, will abide by the rules, and are liable for any incorrect information provided. The parent also undertakes to bear responsibility for the applicant's conduct and pay fees on time.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    of 2

    Mission Foundation Movement

    2022
    Application Form No: ______________
    Estd: 2013

    LAITHANGPUII COLLEGE OF PHARMACY


    A Unit of Mission Foundation Movement

    APPLICATION FORM FOR DIPLOMA IN PHARMACY SESSION : 2022-2024

    Name of Applicant in Capital Letter as recorded in HSLC

    ____________________________________________________________
    Passport size photograph
    to be pasted here
    Name of Applicant’s Father in Capital Letter

    ____________________________________________________________

    Date of Birth (as per HSLC)

    DAY MONTH YEAR SEX


    Religion ____________________________________ Caste ______________________________________

    Place of Birth_____________________________Nationality ______________________________________

    Adhaar No:

    Permanent Address: (H/no, etc.) ____________________________________________________________

    Locality/Veng_____________________________________Town/City_____________________________

    District ______________________________________ State _____________________________________

    Phone no. _____________________________________ Email ___________________________________

    Particulars in entry Qualification School last attended

    Name of Last Examination _______________________________

    Name of Last Examination Board __________________________

    Year of passing _____________________________Full Mark _____________________________________

    Total Marks Obtained _______________________ Division ______________________________________


    (For those who have Higher Qualification than the entry Qualification)
    School last attended_______________________________________________________________________

    Name of last Examination__________________________________________________________________

    Name of last Exam. Board__________________________________________________________________

    Year of Passing:_____________________________________Full mark:_____________________________

    Total Marks Obtained:____________________________Division:__________________________________

    List of Documents to be attached

    Sl. No Documents attached Yes/No

    1. Birth Certificate

    2. HSLC Certificate & Marksheet

    3. HSSLC Certificate & Marksheet

    4. Residential Certificate

    5. Aadhaar Card

    6. Migration for other state

    DECLARATION BY THE CANDIDATE

    My Particulars stated above are true to best of my knowledge and belief. I have read the Prospectus
    and I shall abide by the terms and conditions contained therein. In case of any false statement or in the event
    of being found ineligible even at a later date, I am liable to any actions taken by the Institution as it deems fit
    and proper. I promise to accept and abide by the decision of the Selection Board as final and true.

    ( )
    Signature of Applicant
    DECLARATION BY THE PARENTS/GUARDIAN Date:……………...

    In the event of my son/daughter Mr./Ms……………………………………….. being admitted to


    Diploma in Pharmacy Course in Laithangpuii College of Pharmacy, Zemabawk. I shall bear the responsibility
    of his/her conduct in and outside the Institution. I also undertake to pay his/her couse of study in the said
    Institution from time to time.
    I am aware that according to the rules of the Institution, a minimum attendance of 75% is required in
    lectures and sessionals of each subject of study.
    I will withdraw my son/daughter from the Institution if his/her attendance, progress or conduct are
    found unsatisfactory and also if he/she fails to clear the dues in time.

    ( )
    Signature of Parent/Guardian
    Relationship with Candidate ............................................................................................................................................
    Occupation..........................................................................................................................................................................
    Address for Communication ............................................................................................................................................
    ...............................................................................................................................................................................................
    Mission Foundation Movement 2022

    You might also like