Application for B.Sc. Nursing (NRI Quota)

Application for Admission to B.Sc. Nursing (NRI Quota)

Part 1 : Personal Details

Please enter your name !!
Please enter your Father's or Guardian's name !!
Select Gender !!
Please enter your place of birth !!
Please enter your State !!
Please enter your Mother Tongue !!
Please enter your Nationality !!
Please enter your religion !!
Please enter your caste !!
Please select category !!
Enter your present address !!
Enter your permanent address !!
Enter your mobile number !!
Enter Guardian mobile number !!
Enter your email ID !!
Please confirm your email ID !!

Part 2 : Verification

Please enter OTP

A One Time Password (OTP) has been sent to the mobile number +91 .

Please enter a valid OTP !!
Qualifications
Exam Passed Name and Address of the school Name of Board or University Reg. No. Subjects % of marks obtained with total Year and month of passing Medium of instruction
10th
12th PCBE
All
Marks Obtained in 12th
Subject Maximum Marks Marks obtained Percentage
Physics
Chemistry
Biology
PCB Total
English
Grand Total (PCB and English)
NRI Relative details :
Please enter NRI Relative Name !!
Please enter Relationship with Applicant !!
Please enter address of NRI Relative !!
Please upload Passport of NRI Relative !!
Please enter country of NRI Relative !!

You must make a payment of Rs. 1,500 (Indian Rupees One Thousand Five Hundred only) to the following Bank Account :

Lisieux College of Nursing

Account No : 10470200423724
IFS Code : FDRL0001047

The Federal Bank Ltd.
Mookkannoor Branch

Enter Transaction number (UTR) to complete the application :

Please enter a valid UTR No. !!
Please enter mode of payment !!
Please enter date of payment !!
Please enter name of Account Holder !!
Declaration

I hereby state or affirm that I have filled this form by myself, and to the best of my knowledge and belief, the particulars given are true. I hereby undertake to abide by all the conditions, rules and regulations in force at present and those which may hereafter be introduced for the administration of college. I will do nothing unworthy of a student of the college either inside, outside or anything that will interfere with its orderly working and discipline. I am aware that the management has the full authority to expel me for misbehaviour, continuous failures, found guilty of ragging and for any other valid reasons. I hereby undertake that I shall pay the entire fee and other dues to the institution promptly on demand. I shall pay the college fee for the whole course period if I withdraw from the college any time after the admission and before completion of course. I have thoroughly read the prospectus and understood the contents of it.