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| ADMISSION FORM |
| Personal Information: |
| Name |
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| Permanent Address |
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| DOB |
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Gender |
Male
Female |
| Contact Number |
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Email |
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| Parent's Name: |
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Contact No. |
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| Local Guardian Name: |
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Contact No. |
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| Academic Qualification |
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| Preferred Entrance Programs at VIBRANT |
| i. Medical: |
MBBS
BDS
B.Sc.Nursing
BAMS
BASLP
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| ii. Para-Medical: |
B.Pharm
BPH
BMLT
BMIT
BPT
B.Optom
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| iii. Applied Science: |
B.Sc.AG
B.VSc.& A.H.
B.Sc.Forestry
B.Tech(Food)
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| iv. Foundation Course: |
Science Bridge Course
Staff Nurse
CTEVT
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| v. Others: |
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(please specify) |
| How did you come to know about VIBRANT? |
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| Today's Date: |
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