AeroMed Consultancy — Admission Form

ADMISSION FORM

Please fill all the fields given below

📷 Passport
Photo

Date of Application : / /

▸ Student Information

Full Name

Gender

Male

Female

Other

Date of Birth

Phone Number

Email Address

Course Applied For

MBBS

BDS

BAMS

B.Sc Nursing

Pharmacy

M.Sc Nursing

Preferred Location

India

Abroad

Both

State

10th Percentage / CGPA

12th Percentage / CGPA

NEET Score

Pincode

Present Address

▸ Parent / Guardian Details

Father's Full Name

Father's Phone

Occupation

Mother's Full Name

Mother's Phone

Occupation

ADMISSION FORM

Page 2 — Guardian & Declaration

▸ Guardian Details (if different from parent)

Guardian Full Name

Phone Number

Relationship

Alternative Phone

Address

Pincode

Occupation

For Office Use Only

Application No.

Received By

Date Received

Counselor Assigned

Status

▸ Declaration

I hereby declare that all the information provided in this application form is true and correct to the best of my knowledge. I understand that AeroMed Consultancy will assist in the admission process and that final admission is subject to eligibility and college approval. I agree to the terms and conditions of AeroMed Consultancy.

Student Signature

Parent / Guardian Signature

THANK YOU FOR YOUR REGISTRATION

We will review your application and be in touch shortly.