St. Philomena's College of Nursing

ADMISSION OPEN

The Application should be filled with complete information.

1. Candidate Name in full (as per the certificate)*

2. Father's Name*

3. Mother's Name*

4. Date of Birth*

5. Age*

7. Gender*

7. Place & State of Birth *

8. Blood Group*

9. Religion *

10. Mother Tongue*

11. SC/ST/Others *

12. Caste name*

13. Occupation & annual income of the Father *

14. Occupation & annual income of the Mother*

15. State of Domicile *

16. Permanent Address *

Pincode *

Email ID*

18. Present Address (Address for Correspondence) *

Pincode *

19. Mobile Number of Father *

Email ID of Father *

20. Mobile Number of Mother*

Email ID of Mother*

21. KNC Registration No*

Year of Experience*

22.Speciality*

23. Examination Qualification

Examination:S.S.C

Reg No*

Name of University / Board*

Optional

Medium of Instruction*

Year of Passing*

Max Marks*

Minimum Marks*

Marks Secured*

Total Percentage*

No. of Attempts*

Examination:H.S.C.

Reg No*

Name of University / Board*

Optional

Medium of Instruction*

Year of Passing*

Max Marks*

Minimum Marks*

Marks Secured*

Total Percentage*

No. of Attempts*

Examination*

Reg No*

Name of University / Board*

Optional

Medium of Instruction*

Year of Passing*

Max Marks*

Minimum Marks*

Marks Secured*

Total Percentage*

No. of Attempts*

Examination:Others

Reg No

Name of University / Board

Optional

Medium of Instruction

Year of Passing

Max Marks

Minimum Marks

Marks Secured

Total Percentage

No. of Attempts

22. Are you related to any staff of St. Philomena’s Hospital, Bangalore? *

23.If YES, give the name and relationship.

24. Upload Passport size Image(Image size not more than 900kb.Upload only webp images)*

Enter Captcha Code*

MSc Application Form