Application Form 2020-21

Thanks for registering with Kunwar Ajeet college of Pharmacy! It's free and a simple process.

REGISTRATION APPLICATION FORM FOR COURSE

1. Course Details*Mandatory fields

Course*

2. Applicant's Personal Details

Applicant's full name *

( Full name as per the highest / latest qualification certificate or legal certificate )

Father's Name*

( Full Name As Per Educational/Legal Certificate )

Mother's Name*

( Full Name As Per Educational/Legal Certificate )

Gender*

Date of Birth* (dd-Mon-yyyy)

/ /
( As per high school certificate in 'dd-Mon-yyyy' format. i.e. '01-Jan-1990' )

Category*

3. Contact Details

Mobile Number*

Email Address*

Father's Contact No.*

4. Address Details

Address Line*

City Name*

State*

District*

Pin Code*

4. Educational / Qualification Details

SL.No.	Qualification	Board/University	Passing Year	Marks	Percentage
1.	High School*
2.	Intermediate*
3.	Graduation

5. Qualifying Subjects

Physics Marks	Chemistry Marks	Biology/Math Marks

Upload Photo*

( JPG,JPEG,GIF,PNG image with size upto 50 KB )

6. Declaration

I, hereby declare that the particulars submitted by me in the online application form of KHBS are true to the best of my knowledge and belief. I agree to abide by the rules and regulations of KHBS and also to the decision of KHBS regarding any action. I will not held KHBS responsible for any damages.

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