AMALA SCHOOL OF NURSING

(An undertaking of Amala Cancer Hospital Society)

Amala Nagar P.O, Thrissur - 680555; Ph.No. 0487 2304151, 0487 2304150, 8301832606

Application form for General Nursing & Midwifery Integrated Course For The Year 2022-23

Application Form

Name of applicant (Block letters as in SSLC)

Date of Birth (DOB)

Name of Parent/Guardian (with relationship)

Occupation & Income of the Parent/Guardian

Upload required files (maximum upload file size 1 mb / file)

SSLC certificate
Plus Two certificate
Passport Size Photo

Payment Details

Date of Payment Amount (Rs.)

Declaration by the applicant

I hereby delcare that I have carefully gone through the prospects received along with the application and I promise to abide by the rules and regulations of the institution. The statement made by me in this application and the documents produced in support thereof are true and correct to the best of my knowledge and belief.