Download Admission Form - Peshawar Medical College

Recognized & approved by Pakistan Nursing Council
Affiliated with Riphah International University Islamabad
Post RN B.Sc Nursing (2 Years) Program
Completed Application Form will be submitted to the Principal of College
Fill the form in CAPITAL letters
I) PERSONAL DATA
1. Name of the Students:
(As per SSC or equivalent certificate)
2. Father’s/Guardian Name
3. Father’s Education & Occupation
4. Mother’s Name
5. Mothers Education & Occupation
6. Annual Income of Parents
A project of Peshawar Medical College
ADMISSION FORM
7. Date of Birth Place of Birth
8. Religion Nationality
9. Marital Status Domicile
If married the Spouse Name
Employment
Education
Number of children with ages
10. Permanent Address
11. Address for Correspondence
12. Phone No. Mobile
II) EDUCATIONAL INFORMATION
Examination
Passed
Year of
Passing
Annual /
Supply
Marks
Obtained
Total
Marks
Div./Grade/
Percentage
Name of School / College
Name of Board
SSC /
Equivalent
FSc /
Equivalent
III) OUTSTANDING ACADEMIC ACHIEVEMENTS (IF ANY)
IV) CO-CURRICULAR ACTIVITIES (IF ANY)

V) COMPUTER SKILLS (IF ANY PLEASE GIVE DETAILS)
VI) WILL YOU NEED A SEAT IN HOSTEL Yes______ No_______
GENERAL INSTRUCTIONS
1. Photocopies of the following documents should be attached with the application form
a. SSC (Matric) / Equivalent Certificate and DMC
b. FSc / Equivalent Certificate and DMC
c. NIC / Form B
d. Father’s / Mother’s NIC
2. Original Documents shall be required at the time of interview.
DECLARATION
I hereby declare that the information in the form is correct to the best of my knowledge and belief. I shall abide by
the rules and regulations of Rufaidah Nursing College as stated in the prospectus.
I shall not violate the rules and shall not take part in any kind of harmful activities. If I do so I may be struck off
from the College.
I admit that the College fee and other dues are not refundable whatsoever the reason might be. I shall pay dues in
time. I will attend regular classes and clinical duties.
Date
Signature of the Candidate
=================================
This is to certify that I, _______________________ father/mother/guardian/spouse of above candidate shall be
responsible for regular and in time payment of dues. I shall be responsible for good conduct and welfare of
my______________ __Miss/Mr. During her/his studies and
stay at Rufaidah Nursing College.
Date
Signature of parents/Guardian
Receipt No.
Entry Test Marks
Final Result
FOR OFFICE USE ONLY
Interview Marks
Dated:
Admitted
Not Admitted
_________________________
Chairman Selection Committee