Obstetric & Gynaecological Nursing Medical Surgical Nursing Child Health Nursing (Pediatric) Mental Health Nursing (Psychiatric) Community Health Nursing MANIKAKA TOPAWALA INSTITUTE OF NURSING A constituent CHAROTAR UNIVERSITY OF SCIENCE AND TECHNOLOGY Aegis : Shri Charotar Moti Sattavis Patidar Kelavani Mandal Academic Year : 2020 - 21 Ÿ Accredited Grade “A” by NAAC Application Form for Master of Science in Nursing (M.Sc. Nursing) Form No: Percentage Form Fees : `.500/- City-Dist. 6. RNRM No: _____________________________________ & Program Duration (As per RNRM Certiicate) ________________________ to ________________________ 7. Wish to opt study with earn Scheme : Yes No Form No: __________ Date: ________ /________ / __________ Name :___________________________________________________________ Received By: _______________________ CHARUSAT CHAROTAR UNIVERSITY OF SCIENCE AND TECHNOLOGY E-Mail Mob. Mob. DD/MM/YYYY DD/MM/YYYY

`.500/- CHARUSAT MANIKAKA TOPAWALA INSTITUTE OF NURSING · ¨HSC Mark-sheet ¨Birth Certiicate ¨Reliving Letter ¨Experience Letter ¨Aadhar Card Zerox ü ± The information given

Download PDF Report

Upload
others
View
2
Download
0

Embed Size (px)

Citation preview

Page 1: `.500/- CHARUSAT MANIKAKA TOPAWALA INSTITUTE OF NURSING · ¨HSC Mark-sheet ¨Birth Certiicate ¨Reliving Letter ¨Experience Letter ¨Aadhar Card Zerox ü ± The information given

Obstetric&GynaecologicalNursingMedicalSurgicalNursing ChildHealthNursing(Pediatric)

MentalHealthNursing(Psychiatric)CommunityHealthNursing

MANIKAKATOPAWALAINSTITUTEOFNURSINGAconstituent

CHAROTARUNIVERSITYOFSCIENCEANDTECHNOLOGYAegis:ShriCharotarMotiSattavisPatidarKelavaniMandal

AcademicYear:2020-21Ÿ AccreditedGrade“A”byNAAC

ApplicationFormforMasterofScienceinNursing(M.Sc.Nursing)

FormNo:

Percentage

FormFees: `.500/-

City-Dist.

6.RNRMNo:_____________________________________&ProgramDuration(AsperRNRMCerti�icate)________________________to________________________

7.WishtooptstudywithearnScheme:YesNo

FormNo:__________Date:________/________/__________

Name:___________________________________________________________ReceivedBy:_______________________

CHARUSATCHAROTARUNIVERSITYOFSCIENCEANDTECHNOLOGY

E-Mail

Mob. Mob.

DD/MM/YYYY DD/MM/YYYY

Page 2: `.500/- CHARUSAT MANIKAKA TOPAWALA INSTITUTE OF NURSING · ¨HSC Mark-sheet ¨Birth Certiicate ¨Reliving Letter ¨Experience Letter ¨Aadhar Card Zerox ü ± The information given

FormoreInformation:CHARUSATCampus,ChangaContact:PH.#+91-02697-265201Fax#+91-2697-265011/21Website:www.charusat.ac.inPh:+91-2697-265201/5211E-mail:[email protected]

DECLARATION

We, (“thecandidate”)__________________________________________________________________________________

and (“theguardian)” ___________________________________________________________________________________

herebysolemnlyundertakethat

DatePlaceSignatureofCandidateSignatureofGuardian

DocumentRequired:(Please()TickMark)

¨ FinalYearB.Sc.Nursing/PostBasicB.Sc.NursingMark-sheet¨ RegistrationCerti�icate¨ HSCMark-sheet¨ BirthCerti�icate¨ RelivingLetter¨ ExperienceLetter¨ AadharCardZerox

± The information given above is true. If found false, we understand that theadmissiongrantedwillbecancelledandallfeesforfeited.

± Wehavereadtheadmissionguidelinecarefullyandagreetofollowthem.

± WeshallpaythefeeseveryyearasdecidedbytheManagementoftheInstitute.

± WewillabidebytherulesandregulationsformedbytheInstitute.

CHARUSATCHAROTARUNIVERSITYOFSCIENCEANDTECHNOLOGY