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    Sri Dharmasthala Manjunatheshwara Colleges of Ayurveda Bangalore / Hassan / Udupi, Karnataka

    Uploaded by

    Lalith
    This document is an application form for admission to the Ayurvedacharya (BAMS) degree course for the academic year 2022-23 at Sri Dharmasthala Manjunatheshwara Colleges of Ayurveda in Bangalore, Hassan, or Udupi. The application requests basic personal details such as name, date of birth, contact information, educational qualifications including PUC/12th standard scores and NEET 2022 results. It also asks for details of nationality, religion, caste, family income and goals. The applicant and parent must sign to declare that the information provided is true.

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    Sri Dharmasthala Manjunatheshwara Colleges of Ayurveda Bangalore / Hassan / Udupi, Karnataka

    Uploaded by

    Lalith
    72 views2 pages
    This document is an application form for admission to the Ayurvedacharya (BAMS) degree course for the academic year 2022-23 at Sri Dharmasthala Manjunatheshwara Colleges of Ayurveda in Bangalore, Hassan, or Udupi. The application requests basic personal details such as name, date of birth, contact information, educational qualifications including PUC/12th standard scores and NEET 2022 results. It also asks for details of nationality, religion, caste, family income and goals. The applicant and parent must sign to declare that the information provided is true.

    Original Title

    UG_BAMS_Application_2022-23

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    This document is an application form for admission to the Ayurvedacharya (BAMS) degree course for the academic year 2022-23 at Sri Dharmasthala Manjunatheshwara Colleges of Ayurveda in Bangalore, Hassan, or Udupi. The application requests basic personal details such as name, date of birth, contact information, educational qualifications including PUC/12th standard scores and NEET 2022 results. It also asks for details of nationality, religion, caste, family income and goals. The applicant and parent must sign to declare that the information provided is true.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    72 views2 pages

    Sri Dharmasthala Manjunatheshwara Colleges of Ayurveda Bangalore / Hassan / Udupi, Karnataka

    Uploaded by

    Lalith
    This document is an application form for admission to the Ayurvedacharya (BAMS) degree course for the academic year 2022-23 at Sri Dharmasthala Manjunatheshwara Colleges of Ayurveda in Bangalore, Hassan, or Udupi. The application requests basic personal details such as name, date of birth, contact information, educational qualifications including PUC/12th standard scores and NEET 2022 results. It also asks for details of nationality, religion, caste, family income and goals. The applicant and parent must sign to declare that the information provided is true.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    II OM SHREE MANJUNATHAYA NAMAHA II

    Application No.
    Sri Dharmasthala Manjunatheshwara Colleges of Ayurveda
    Bangalore / Hassan / Udupi, Karnataka
    (Affiliated to Rajiv Gandhi University of Health Sciences, Karnataka, Bangalore)
    Managed by: Sri Dharmasthala Manjunatheshwara Educational Society (R), Ujire-574240, DK, Karnataka
    Affix your recent
    APPLICATION FOR ADMISSION TO AYURVEDACHARYA (B.A.M.S.) DEGREE passport size
    COURSE FOR THE ACADEMIC YEAR 2022-23 photograph

    Please email filled application to: ayuugadmission22@sdmesociety.in


    Fee Rs. 500/- may be payable online through NEFT to Principal, SDM College of Ayurveda,
    Hassan, Bank of Baroda, IFSC:BARB0VJSCAH, A/c No: 63900200000086
    Zero
    Transaction Id / UTR No & Date:
    2 1 3
    Order of Preferred College: Bangalore Hassan Udupi (E.g. Bangalore Hassan Udupi )

    1 Name of the applicant in full (BLOCK LETTERS)


    as in SSLC Marks Card / Birth Certificate
    2. Father’s Name in full (BLOCK LETTERS)
    3. Mother’s Name in full (BLOCK LETTERS)

    4. Sex: Male Female


    D D M M Y Y Y Y Age
    5. Date of birth as per School records &age

    6. Permanent address with PIN code


    Door No / Lane / Street
    City / Village
    Taluk
    District : State:

    PIN:
    7. Mobile Number – Parent Student Mobile

    8. Email (Parent) Email (Student)

    9. Details of Pre-university (PUC) examinations passed

    Name of qualifying Examination Reg. No. Month Year


    Name of the College studied:

    Board to which it is affiliated:

    Sl Subject Max. Marks Marks obtained %


    1. Physics
    2. Chemistry
    3. Biology
    Total
    10. National Eligibility cum Entrance Test (NEET-2022) Score Details
    Reg. No. Category (UR/SC/ST/OBC) Rank Mark Percentile
    11. Nationality : Indian Other , Give details:
    12.
    Place of Birth: Village/Town/City …………………………………………..
    Taluk_________________________________ District_______________________________

    State_________________________________
    PIN:
    13. Religion & Caste
    Religion: Caste:
    If belonging to any one of the categories, the
    (i) SC (ii) ST (iii) GM (iv) Cat-I
    same is to be indicated by √ mark
    (v) Cat-II (A)/(B) (vi) Cat-III (A)/(B) (vii) Other
    14. Mother Tongue Annual Income of Parent
    Occupation of the Parent
    15. Source of information regarding the SDM Ayurveda Colleges : Please tick mark

    Self College Website Alumni Practitioners Govt. agencies Embassy Other if any

    specify Recommended by ……………………………………………………..


    16. Achievements if any (District / State / National level)

    1.Curriculum

    2. Co-Curriculum

    3. Extra - Curricular (Specify any) a. Sports b. Fine arts

    17. Goal you want to achieve after graduation


    Life Goal:

    Professional Goal:

    18. Documents to be emailed to ayuugadmission22@sdmesociety.in (Please tick)


    i. NEET-2022 Marks Sheet iv. Caste Certificate
    ii. SSLC / Xth Marks Card / Birth Certificate v. Income Certificate
    iii. Pre University / XII StdMarks Card vi. Aadhar Card / Nationality Certificate/Passport

    DECLARATION BY THE APPLICANT& PARENT


    We hereby declare that the above said information is true to best of our knowledge.

    Place:
    Date: Signature of the Applicant Signature of the Parent

    For Office Use

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