GOVERNMENT OF ANDHRA PRADESH
PARAMEDICAL SCIENCES COMMON EXAMINATIONS
 

APPLICATION FORM FOR CERTIFICATE & DIPLOMA COURSES

Centre Name          :

NB: Application form must be filled in by the student’s own handwriting.

1.  Name of the Candidate        :   

2. Father’s Name                     :
3. Date of Birth & Age :        

4. Educational Qualification       :

5. Permanent Address :  

6. Name of the Paramedical      :

    Institution in which the

   Student is studying

7. Name of the course of Study:

8. Date & Year of Admission:

9. Examination fee particulars: Amount Rs                     / DD No.                        Date    

10. Particulars of Previous

      Examination if appeared  : Date                     Registration No.                    

11. Subjects in which the candidate is to be examined.

 

Certificate course

Diploma Course

 

 

 

 

 

 

 

 

 

 

 

Signature of the Principal

of the Institution with Seal                                                            Signature of the Candidate

Complete Postal Address of Institution                                           Tel.No .of Institute

                                                                                                   Cell phone.No.of Contact Person of Institute

 

                                                                                                    E-mail address of Institute