The Anjali college of Pharmacy & Science

Date

Name of Student

Email Address

Gender
MaleFemaleOthers

Date of Birth

Select Category

Select Sub-Category

Father's Name

Mother's Name

Student Contact No.

Parent Contact No.

Address

Course of interest (for admission purpose)

Nationality

Region

GPA / %age in 12th

Year of Passing

Additional Information (If Applicable)* :
Name of Diploma / Degree

%age / CGPA in any other diploma / degree

Graduated in which year

*Eligibility required as per Programmes as decided by the University.