Admission Form - Diploma in Nursing Science & Midwifery | Peoples International Nursing College

Admission Application Form

Courses for admission *

Photo * Choose File No file chosen

Personal Information

Name of Candidate *

Father's Name *

Mother's Name

Age

Date of Birth

Place of Birth

Nationality

Religion

Permanent Address

Present Address

Tel/Mobile (Student) *

Father/Mother Mobile *

Local Guardian

Name of Local Guardian

Guardian Mobile

Local Guardian Address

Relation

Occupation

Tel/Mobile

Blood Group

Academic Profile

Name of Exam	Group	GPA/Grade/Division	Year	Institute	Board
SSC / Equivalent
HSC / Equivalent
Diploma in Nursing Science and Midwifery / Orthopaedics

Admit Roll *

Test Score

Merit Position

Document Uploads

SSC Certificate Choose File No file chosen

SSC Mark-sheet Choose File No file chosen

HSC Certificate Choose File No file chosen

HSC Mark-sheet Choose File No file chosen

Admission Test Admit Card Choose File No file chosen

Diploma in Nursing Science and Midwifery Certificate Choose File No file chosen

Diploma in Nursing Science and Midwifery Registration Card Choose File No file chosen

NID or Birth Certificate Choose File No file chosen

Payment (Manual)

bKash Bank

Send the fee to bKash number: -, then enter the Transaction ID below.

bKash Transaction ID

bKash Transaction Ref

Deposit the fee to: -
A/C Name: - | A/C No: -
Then enter your bank name and transaction/reference ID below.

Bank Name (you paid from)

Transaction / Ref ID

Note

Declaration

I declare that all information, mark-sheets and certificates provided are true and I will not apply for cancellation after admission is closed.
I agree to follow all course fee rules. Fees paid during admission are non-refundable and cannot be transferred to another course.
Peoples International Nursing College authority reserves the right to cancel my registration fee if the admission is cancelled after confirmation.
I will pay the yearly tuition fee within the fixed time as per notice.
I confirm that I have no unresolved disciplinary issue with any previous institution and I will provide supporting documents if required.
I will abide by the rules and regulations of the college/institution, Bangladesh Nursing and Midwifery Council and Bangladesh Government.
I will remain free from ragging, drugs, smoking, gambling and any other disciplinary offence, failing which I shall be fully responsible.
Institution authority's decision regarding admission and any other matter shall be final.

I have read and agree to the above declaration *

Name of Applicant *

Address of Applicant *

Date

Registration fee: ৳12,000