MGM

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MGM silver Jubilee College of Pharmaceutical Sciences

MGM Pharmacy College Ernakulam Dist, Kerala -686667, Kerala Approved by PCI AND Affiliated to Kerala University of Health Sciences

APPLICATION FOR ADMISSION TO B. PHARM DEGREE COURSE 2025-2026 UNDER MANAGEMENT QUOTA

Name of the Candidate (In block letters)

Permanent Address

Address For Communication

Gender

Date of Birth

Age

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Nationality

Religion

Community

ENGLISH

Mark Obtained

Maximum Marks

Grade

Subject

MALAYALAM

Mark Obtained

Maximum Marks

Grade

Subject

PHYSICS

Mark Obtained

Maximum Marks

Grade

Subject

CHEMISTRY

Mark Obtained

Maximum Marks

Grade

Subject

BIOLOGY

Mark Obtained

Maximum Marks

Grade

Subject

MATHEMATICS

Mark Obtained

Maximum Marks

Grade

Grand Total

Total Percentage

Total of Physics + Chemistry + Biology/Mathematics/ Computer Science

Details of Entrance examination

Rank

Subject

Mark Scored

In Figures

In Words

Subject

Paper I(Physics & Chemistry)

Mark Scored

In Figures

In Words

Subject

Total Marks

Mark Scored

In Figures

In Words

Details of Marks secured in the SSLC examination

Board of Study

Total % of marks

Quota

Declaration

We, the applicant & parent / guardian do hereby declare that all the information furnished above are true and correct and we will obey the rules and regulations of the institution, if admitted. Also we understand that the admission shall be, subject to satisfying the eligibility norms prescribed by the Statutory Authorities and the State Govt. from time to time.

Place

Date

Signature of the Parent

Signature of the Applicant

FOR OFFICE USE ONLY

Certified that the candidate has passed the qualifying examination mentioned and I have verified the original mark list with the entries made above and found correct.

Place

Date

Signature of Principal

Name

Designation

The above candidate is admitted Provisionally to …………………………………………………………. on …………………………………………………………. under Management Quota.

Signature of Principal