GNM

May 30, 2020

ST. PHILOMENA’S SCHOOL OF NURSING

St. Philomena’s Hospital No.1 Mother Theresa Road, Viveknagar PO, Bangalore

Application for admission to GNM Nursing


Note:

1. The Application should be filled with complete information. Kindly take a screenshot of the filled application form, before submitting it. You are expected to mail the screenshot to admissionspcon@gmail.com to help us identify you in case of technical adversities.

2. Kindly feel free to contact us, (+91 73491 19253 - SPCON admission Enquiry Number) in case you have not received a reply from us within seven days of submission of your application.

3. Incomplete application and those without the required documents will not be considered.

4. Students awaiting their PUC /+2 results can apply with their SSLC marksheet.


Please do the payment first (please find the payment details below) and then fill the application form

Enter Payment Reference Number:

Candidate Photo:

Candidate Name (As per the certificate/Name in Block Letters) in full :

Father’s Name :

Mother’s Name :

Date of Birth

Age :

Place & State of Birth :

Blood Group:

Religion :

Mother Tongue:

SC/ST/OBC/Other :

Caste name :

Occupation & annual income of the Father :

Occupation & annual income of the Mother :

State of Domicile :

Permanent Address :

PIN Code : Email Address :

Present Address (Address for Correspondence) :

Mobile Number & Email ID of Father :

Mobile Number & Email ID of Mother :

Educational Qualification:

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
1. S.S.L.C
2. H.S.C.
3. Others

Attach all your S.S.L.C educational documents :

Attach all your H.S.C educational documents:

Attach all your Other educational documents:

Are you related to any staff of St. Philomena’s Hospital/College of Nursing, Bangalore?YesNo

If YES, give the name and relationship :

Date :


Payment Details:-

Bank Name : The South Indian Bank Ltd

Branch : St.Philomena’s Hospital Branch, Bangalore – 560 047

A/c No: 0593053000002519

IFSC Code : SIBL0000593


Application Fee – Rs.500/-


For Office use only: