CHARKOS COLLEGE OF NURSING

A Unit of Sunanda Education Trust (R) Reg No. 40 / 98-99

Affiliated to Rajiv Gandhi University of Health Sciences, Bangalore

Recognised by Government of Karnataka, Karnataka State Nursing Council & Indian Nursing Council

No.5, C-1, A-1 Block, 3rd Stage, Vijayanagar, MYSURU - 570030.

Pre-Enquiry Admission Form

Student Information

Name of the Applicant

Please enter the student's name

Gender

Male

Female

Date of Birth

Email Id

Student Contact Number

Nationality

Aadhaar Number

Religion

Caste

Mother Tongue

Marital Status

Single Married

Educational Qualification

Class to which admission is sought

Finance

Parent Details

Parent

Name

Contact Number

Occupation

Aadhar

Guardian's Details

Name

Guardian's Contact Number

Guardian's Occupation

Guardian Aadhar

Present Postal Address

Permanent Postal Address

Medical disability (if any)

If yes, please attach the medical fitness certificate.

No Yes

Student Academic Records

Examination	Medium of Instruction	Maximum Marks	Marks Obtained	Total Percentage	No. of Attempt
SSLC / 10th
PUC / 10+2

Marks Secured in Qualifying Examination

Sl. No.	Subject	Maximum Marks	Marks Obtained	Percentage	Action
1
TOTAL		0.00	0.00	0.00

Upload Files

Recent Photo of the Applicant

10^th Marks Card

12^th Marks Card

Applicant's Aadhar

Transfer Certificate of the Applicant

Caste Certificate

Medical Fitness Certificate

Declaration

I/We declare that the above information provided herewith is true to the best of our knowledge. We fully agree to abide by all the policies, rules and regulations of the institution from time to time, and can in no way complain about or not accept the verdict of the institution as final. I/We also understand and accept that in case of discontinuation of the course for any reason, I/We shall forgo the entire fee, including deposits paid to the institution, and shall not claim any reimbursement or compensation.

I have read and agree to the declaration.

Important Instructions

The application should be accompanied by the following:
Copy of SSLC / 10th marks card
Copy of PUC / 10 + 2 equivalent examination
Conduct certificate from previous institution
Copy of transfer certificate
4 recent passport size photographs
Medical fitness certificate
Migration certificate (for non-Karnataka students only)
Original certificates should be submitted with this form.
Duly completed application should reach the Principal, Charkos Group of Institutions, No. 5, C-1, A-1 Block, 3rd Stage, Vijayanagar, Mysuru - 570030.
Advance Payment or other fee to be made in favor of Sunanda Education Trust, A/C No: 50200067752242, HDFC Bank Ltd, IFSC Code : HDFC0000065.

For Office Use Only

I have checked and verified all information and supportive documents and declare that the candidate is admitted for the course.

Date:

Receipt No.:

Amount Collected:

Admitted by

Principal