Application Form

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Application Form

Proposed Course

Enter Your Officially Documented Name

IDCARD Photograph (Passport size)

Date Of Birth

Age

Gender

Father Name

Mother Name

Religion

Nationality

Domicile Karnataka

Community

Blood Group

Address

This where all our correspondences & application template will be sent. Make sure you keep it up dated data. If any changes you may prompt us as early.

(E.g. Parents, Relatives – this address will be supportive in the event of inability to contact you at your main contact address).

Main Contact Address

Alternative Contact Address

Father's Mobile No

Mother's Mobile No

Email Address

Residence Address

City / Town:

Mobile No

Day Time Telephone

Email Address

WhatsApp Number

Please indicate the relationship With the Gurardian

Relative Family Friend Others

Previous Higher Education / Qualifying Examination

Name of the University

Name of the College

Obtained Degree

Marks Card in Qualifying Examination

Marks card Of Gratuation (All 3 years)

Transfer Certificate

Degree Certificate

Nationality Certificate (only of International Students)

Migration Certificate

Any Other

Student Declation

I agree to abide by the laws and regulations of the Padmashree Group of Institutions (PGI)

I acknowledge that if I am accepted for a course of the study I am liable to pay the fees for the full term and it will not be refunded under any circumstances

I am aware that 80% attendance is mandatory in all the subjects for a student to be eligible to appear for the University Examinations.

I acknowledge that I am aware about the payment of Hostel development Fund of Rs. 10,000/- which is nonrefundable.

I am aware that it is mandatory for all the students to stay in the hostel and agree to abide by this condition for the full tenure of my educational course at PGI

I am aware that consumption alcohol and smoking is prohibited in the college and hostel and I agree to abide by this condition failing which necessary disciplinary action can be taken against me.

I am aware that usage of two wheelers is not allowed in the college campus and in the hostel.

I hereby agree that I will not cause any damage to college and hostel property.

I accept that failure on my part to abide by this policy may lead to necessary disciplinary action and any related cost incurred by my actions will be recovered by me.

I am aware that delay in payment of the hostel fees attracts late fee (fine) until such time as I have paid the same.

I agree that it is an essential term of my agreement with PGI that information I have furnished in this form and any attached documents is true and complete and I acknowledge that PGI may suspend my enrolment if false information has been supplied or required information is not supplied by the due date.

Signature Of the Student

Date & Place

Father / Mothers / Guardian's Name

Proposed Course

Enter Your Officially Documented Name

Date Of Birth

Age

Gender

Father Name

Mother Name

Nationality

Blood Group

Email Address

Mobile No

WhatsApp Number

Main Contact Address

Previous Higher Education / Qualifying Examination

Name of the University

Name of the College

Obtained Degree

Marks Card in Qualifying Examination

Marks card Of Gratuation (All 3 years)

Transfer Certificate

Degree Certificate

Nationality Certificate (only of International Students)

Migration Certificate

Any Other

Date & Place

Father / Mothers / Guardian's Name

Affiliated to:

Rajiv Gandhi University of
Health Sciences

Recognized by:

Government of Karnataka

Indian Association of Physiotherapist

Padmashree Group of Institutes nurtures talent and fosters innovation to prepare future leaders. With a focus on academic excellence and holistic development, our diverse range of programs, experienced faculty, and state-of-the-art facilities empower students to achieve their goals.