Application Form for 3 Years Course in GNM 2021-2022, Government of Meghalaya

Directorate of Health Services (MI), Government of Meghalaya

APPLICATION FORM FOR 3 YEARS GENERAL NURSING AND MIDWIFERY (GNM) 2021-2022

Print Application Form

(General Instructions: 1. All fields are mandatory. 2. Enclosures: Mandatory - Passport size photograph, Age proof [ Birth Certificate/Class X Admit Card], Class XII Marksheet. Optional - ST/SC Certificate, Permanent Residential Certificate (For Non-ST/SC), Disability Certificate)

Name of Candidate

Gender

Date of Birth

Age (as on 31/12/2021):

Mobile No.

Category

% of Marks in Class XII

Stream in Class XII

Physically Disabled Yes

Parent's /Guardian's Name

Permanent Address

Same as above
Address for Communication

Enclosures:

Passport size photo
(Max 400KB) Image file only

Age Proof
(Max 500KB) Image file only

Class XII Marksheet
(Max 500KB) Image file only

ST/SC Certificate
(Max 500KB) Image file only

Permanent Residential Certificate
(Max 500KB) Image file only

Disability Certificate
(Max 500KB) Image file only

Enter Text

I do hereby declare that the statements made above are true to the best of my knowledge and belief. In case the statements are found incorrect, my application is liable to be rejected.