Asha Paramedical & Nursing Institute

Salbari Bazar, Siliguri, Darjeeling, West Bengal-734002

Tel: +91 8597600878 | Email: ashaparamedical@gmail.com / info@ashaparamedical.com

Website: www.ashaparamedical.com

Scholership Form

Choose Course

Name of The Applicant

Gender

Date Of Birth

Blood Group

Religion

Caste

Mother Tongue

Adhar Card No.

Correspondences Address

Pin Code

Mobile No.

Phone

E-mail

Passport Size Photograph

Parents/Guardians Information

Name Of The Father

Occupation of Father

Name Of The Mother

Occupation of Mother

Address of Parents

Pin Code

Mobile No.

Phone

E-mail

Details Of Educational Qualifications

S. No.	Qualification	Name of the School/College	Subject	Percentage	Year Of Passing