Tagore Paramedical Institution Anbarasu School of Nursing

Anbarasu Institute of Medical Science

& Research

 
Anbarasu Institute Of Medical Science and Research Center
School of Nursing - Application Form

Dr.C.Anbarasu and Dr.Rajabathar Educational Cultural and Charitable Trust(Regd.)
Approved by the Govt.of TamilNadu
G.O.No.Ms.No.822,823,&824 Dt.10.6.93 and by the
Tamil Nadu Nursing Council in Lr.No.245/NC/14.11.94
INC No/Aug/2010 dt.22.09.2010 and by the Indian Nursing Council
T.T.K Nagar, Irumbuliyur, Tambaram,Chennai - 600 045
Telephone: 044-64555006, 42150448  Mobile: 9381384866, 9381384844
E- mail : tims.tambaram@gmail.com
 
Select The Course *  
Name * :
Gender * :
Place of Birth * :
Date of Birth * :
Email Id * :
Mobile Number * :

Correspondence Address in full *
(to which reply to this application may be sent)

:
Name and Address of the local Gurardian * :
Father's Name (Guardian's Name & Relationship), Occupation, his/her permanent address and contact number. :
Mother Name * :
Nationality * :
Caste * :
Candidates Domicile State * :
Name and Address of the Parent/Guardian * :
Occupation of the Parent/Guardian * :
Annual Income of the Parent/Guardian * :
Languages which the candidate can Speak/Write/Read :
Details of Educational Qualification * :  
Years Examination Passed Board / University Division % of Marks
     
If Passed in More than one attempt, give details :
HSC, University or Equivalent Exams * :  
Years of Passing Register Number Subject Marks Obtained Maximum Marks
     
Name of two references with designation and address of persons not related to the applicant
Reference No.1 (Name / Mobile No. Need to Enter)* :
Reference No.2 (Name / Mobile No. Need to Enter)* :
Marital Status * :
Blood Group :
Extra Curricular Activities * :
eg : Sports, Games, N.C.C, N.S.C, Scouting etc...

List of Certificates / Documents attached to this application in Zip or Rar file

a. Two Copies of recent photographs, duly attested by a Gazetted Officer :
b.Attested / Xerox copies of High School and Higher Secondary Certificate issued by the Examination :
c. Last Board Transfer Certificate / School Leaving Certificate :
d. District Magistrate's certificate, if the candidate belong to Schedule Caste / Schedule Tribe :
Hostel Facility Required * :
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Attach Your Certificates in .Rar or .Zip Format
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* Please Note that Improper Pictures Will be rejected and will not be considered as a valid Application.
   
 
   
 
Nursing Course