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Tagore Paramedical Institution Anbarasu School of Nursing

Tagore Institute of Medical Science
& Research Center

Application  :   Print
Application Form
30/B, L.B. Road, Thiruvanmaiyur, CHENNAI -45
43, G.S.T Road, M.R. Theatre Complex, Tambaram, Chennai - 600 045, TamilNadu, India
Telephone: 044-64555006 Mobile: 9381384866 ,9381384844.
E- mail : tims.tambaram@gmail.com
Application Id :
Name of the Applicant :
Course applied for :
Amount :
Gender :
Place Of Birth :
Date Of Birth :
E-mail ID :
Mobile Number :
Date of Birth :
E-mail ID :
Mobile Number :
Correspondence Address in full
(to which reply to this application may be send)
Father Name(Guardian's Name & Relationship)Occupation, his/her permanent Address & Contact Number :
Name & Address Of the Parent/Guardian Occupation of the Parent/Guardian. :
Languages Which the Candidate can Speak/Write/Read :
Reference :
Details of Educational Qualification :  
Year Examination Passed Board / University Division % of Marks
Whether admission is for day or evening college or weekend :
Work Expriences :
Payment Mode :
Payment Status :
Register Date :
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 :
Attach Your Passport Size Photo :
Attach Your Certificates in .Rar or .Zip Format :
I hereby declare that information furnished is true & correct. I will abide by rules & regulation of the institute given below

1.Foreign students should submit Xerox copy of the passport & visa
2. All the fees becomes payable within 7 days from the date of receipt of intimation of admission
3. Fees once paid will in no case be refunded whether the candidate is unable to join or pursue the course
4. Student should be punctual and regular in attendance
5. Misconduct: student found wanting in punctuality , attendance and conduct are liable for removal from the institute
6. Medium of instruction: student will be taught in English, explanation will also be given in Tamil.
7. punctuality & attendance 75% attendance is compulsory to write the examination
8. Right to suspend: right to suspend/expel/ debar a student, vest with management to maintain good name of the institute.
9.The use of mobile/ cell phone is strictly prohibited in the class room.
Office Use Only
Station   Signature of Applicant


  Signature of Candidate
Principal   MD