June 1, 2020
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.
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 :
Gender :MaleFemale
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 :
Concerned State Nursing Council Registration No :
Year of Experience :
Sepciality :Medical Surgical NursingOBG NursingMental Health Nursing
Educational Qualification:
Attach all your S.S.L.C educational documents :
Attach all your H.S.C educational documents:
Attach all your B.Sc(N)or PB.B.Sc(N) 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 : 0593053000002518
IFSC Code : SIBL0000593
Application Fee – Rs.750/-
For Office use only:
