Approved by Pharmacy Council of India, Govt. of India Affiliated to Dr. A.P.J. Abdul Kalam Technical University, BTE UP, Lucknow
Date
Name of Student
Email Address
Select Gender MaleFemaleOthers
Date of Birth
Select Category -- Choose Category --GeneralSCSTOBC Select Sub-Category -- Choose Sub-Category --PHDPNCCNone of the above
Father's Name Mother's Name
Student Contact No. Parent Contact No.
Address Course of interest (for admission purpose) Select Course*D. PharmB. PharmM. Pharm
Nationality Region -- Choose Region --U.P.Outside U.P.
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
I authorize ANJALI COLLEGE OF PHARMACY AND SCIENCE and its representative to contact me with updates and notifications via Email, SMS, WhatsApp, and Call. This will override the registry on DND / NDNC.
