Same as permanent Address
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Marks Obtained*

Subjects Maximum Marks Marks Secured Percentage No. of Chances
Physics
Chemistry
Biology
Mathematics
Computer Science
Biotechnology
Total Marks
Total Marks obtained for both Physics & Chemistry Percentage obtained for both Physics & Chemistry

Application Fee Details

DD No Date Bank Amount

Declaration*

I do hereby declare that the particulars given in the application are true to the best of my knowledge and belief. If any of the particulars given by me in this application is proved fraudulent at any later stage of admission, I shall be liable for disciplinary action and my admission shall become null and void. I shall produce the originals of the certificates at the time of interview. I carefully read the prospectus thoroughly and I am ready to abide the terms and conditions mentioned in the Prospectus.
Place:
Date:
Name & Signature of the Candidate:
Name & Signature of Parent or Guardian

Declaration *

I do hereby declare that the particulars given in the prospectus are carefully read and understood. I carefully read the prospectus thoroughly and I am ready to abide the terms and conditions mentioned in the Prospectus.
Place:
Date:
Name & Signature of the Candidate:
Name & Signature of Parent or Guardian

Notes:
  • Duly filled application form along with relevant documents and DD for Rs. 1000/- in favour of ‘Kerala State Self Financing Pharmacy College Management Association’ Payable at Chalakudy, should be submitted to the office of the college on or before the prescribed date in Notification.
  • Applications received after the prescribed date will not be entertained under any circumstances.
  • Application forms not supported by relevant documents will not be considered.