Online Admission Form

Class *

Section *

First Name *

Last Name

Gender *

Date Of Birth *

Mobile Number

Email *

Nurse Photo

Nationality *

High School Name *

Nursing School Name *

Highest Nursing Degree Obtained *

Institution Granting Nursing Degree

Year of Graduation *

Country of Education *

Current Employer *

Current Workplace Location *

Current Department/Unit *

Clinical Specialization *

Total Years of Nursing Experience *

If Unemployed, Please Specify the Reason *

Current Residential Address *

Reason for Registering / Professional Goals *

Type of Government ID (e.g., IC, Indian Passport) *

Passport/IC Number *

ID Expiry Date *

If Guardian Is * Father Mother Other

Guardian Name *

Guardian Relation *

Guardian Email

Guardian Address

Permanent Address

Documents (Upload nurse and school-related files as one compressed file.)