Mount Zion Institute of Allied Health Science| Application

Application Form

Upload Photo *

Upload Signature *

Course Applied *

Name of Candidate *

Personal Data

Date of Birth

Age *

Place of Birth

Gender

Male

Female

Transgender

Blood Group

Nationality

Religion *

Denomination *

Address to which communication may be sent *

Applicant Contact No *

Father’s / Guardian’s Name

Mobile

Pincode

Land Phone No.

Father’s / Guardian’s Occupation *

Annual Income *

E-Mail

Name of the School / College last attended *

Qualifying Examination Passed *

Month & Year of Passing

% of Marks obtained in the Qualifying Examination (P+C+B+E) subject only

II PUC / +2 Marks Sheet *

I here by declare that the information given above is correct. With my guradian as witness,I hereby promise that if i am admitted to this college, I shall abide by all the rules of the college, and day-to-day instructions of the principal. I further promise that I shall not in any way get myself involved in strikes or boycotting examination, or persuade others to do so.I shall not take part in any organised activity against the college or university.

Signature of the Applicant