BISHOP BENZIGER COLLEGE OF NURSING
(KUHS Centre of Research; Accredited by NAAC & KUHS QAS Accredited with A+)
Post Box No.46, Sastri Jn.
Kollam-01, Kerala
Tel:0474-2765582
APPLICATION FOR ADMISSION UNDER NRI QUOTA 2024-25
B.Sc. NURSING
New Application
Name of the applicant
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Age
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DOB
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Gender
Religion & Caste
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Nationality
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Name of the Parent/Guardian
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Postal Address
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Telephone Number
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Mobile Number of Parent/Guardian
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E-mail Address
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Educational Qualifications
Qualification
Board of Examination
Name of the Institution
Month & Year of Passing
Reg No
Marks Secured
Grand Total
Percentage %
S.S.L.C
Board of Examination
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Name of the institution
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Month & Year of Passing
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Register No
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Mark Secured
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Grand Total
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Mark %
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Plus Two
Board of Examination
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Name of the institution
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Month & Year of Passing
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Register No
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Mark Secured
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Grand Total
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Mark %
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Marks obtained in Plus Two Examination (Second Year Only)
Subject
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Max. Mark
Percentage of Mark
Physics
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Chemistry
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Biology
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English
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Total Marks (PCBE)
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Sponsor Details
Name of the Sponsor
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Relationship with the applicant
Valid Passport No
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Date of Expiry
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Valid Visa No
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Date of Expiry
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Postal Address (Indian)
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Postal Address (Abroad)
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Mob. Number
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E-mail Address:
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Declaration
We, ___________________________ (Applicant)& ___________________________ (Parent/Guardian) do hereby solemnly declare that the statements made herein above are true to the best of my knowledge and belief. Should the said information prove to be incorrect at any stage, my candidature/admission to the B. Sc. Nursing course shall stand cancelled. We promise to submit all certificates and documents in original at the time of admission failing which the admission will be liable for cancellation. We agree to pay an additional fee of Rs. ____/- every year as per Government Order. Therefore, those who leave the course after the closure of admissions will have to execute a bond along with anyone of the candidate’s guardian/parent undertaking to pay the college the amount that would be ordered by the AFRC / Court of Law. The member colleges shall return all the certificates/ documents of the candidate along with TC on execution of the above bond..
Name of Applicant
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Applicant Signature
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Name of Parent/Guardian
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Parent/Guardian Signature
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Date
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Place
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Documents attached
Copies of the documents are to be attached here. Original documents and certificates are to be handed over to the college at the time of admission.
Student's Photo
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X th Certificate in proof of Date of Birth
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Copy of the marks sheet of qualifying examination certificate ( plus 2)
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Character/Conduct certificate from the institution last attended within six months.
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Transfer Certificate
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Migration Certificate
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Sponsor’s Embassy attested copy of valid passport
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Sponsor’s attested copy of green card/ employment certificate/ Visa (Overseas employment certificate)
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Relationship certificate of student with sponsor from concerned revenue authority
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Completed copy of Affidavit in Stamp Paper worth Rs.200/-(Annexure-I) duly notarized by Notary Public
Please Upload Completed copy of Affidavit in Stamp Paper worth Rs.200/-(Annexure-I) duly notarized by Notary Public.!
Eligibility Certificate from Kerala University of Health Sciences Trissur, if candidate completed her plus two in foreign country (If applicable)
Please Upload Eligibility Certificate from Kerala University of Health Sciences Trissur, if candidate completed her plus two in foreign country (If applicable).!
Equivalence Certificate from Association of Indian Universities (if applicable)
Please Upload Equivalence Certificate from Association of Indian Universities (if applicable).!