May 30, 2020


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

Application for admission to GNM Nursing

Note: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 to help us identify you in case of technical adversities.

Please do the payment first and then fill the application form

Enter Payment reference Number:

Application No

Candidate Photo:

Candidate Name 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

Narration : Strictly write Application No. first and Applicants Name

If not office is not responsible since we cannot trace the applicant

Application Fee – Rs.500/-

For Office use only:


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