Nursing/ Paramedical /Pharmacy Registration Form Personal Details Residential Status (Rural/Urban): RuralUrban Do You Have Any Physical Challenge? : YesNo NextCourse Details Nursing/ Paramedical/ Pharmacy: College Preference: AssamWithin NortheastOutside Of Northeast College/ University Name: BackNextParents Details BackNextAddress Details Is Permanent Address same as Present Address? YesNo BackNextMatriculation / SSC / Xth Details XIIth Details (Incase Intermediate / HSC / XIIth is Appearing) BSc Nursing/ CEE Details Have You Appeared CEE/Paramedical/ B Pharm Entrance Exam? YesNo If Appeared please upload your Admit card Documents Supported file gif|jpg|jpeg|png|pdf File Size Maxumum 2 MB Passport size photo: 10th Marksheet: 12th Marksheet for Undergraduate: Signature: Declaration I declare the information provided by me is true in all respect and in case any information found to be false, my scholarship would stand cancelled automatically. UNDERTAKING OF PARENT / GUARDIAN I have read the declaration made by my son/ daughter/ward as above and endorse the same. Back
