K. K. Wagh Pharmacy Institutes, Nashik

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

K. K. Wagh Pharmacy Institutes, Nashik

Dear Student,
We understand you are appearing for XIIth Sci. Exam this year.
It is an important exam to decide your future and career- ALL THE VERY BEST FOR GOOD PREPARATION & RESULTS.
If you are interested in Pharmacy career (B.Pharm / D.Pharm)- please fill and submit the form.

Sign in to Google to save your progress. Learn more

* Indicates required question

Your Name (As per SSC Marksheet) *

Your answer

Student Mobile Number / WhatsApp No *

Your answer

Gender *

Female

Male

Prefer not to say

Other:

Detail Address *

Your answer

Pincode *

Your answer

Which group do you have in 12th science? *

PCM

PCB

Both PCB and PCM

Are You Interested in Pharmacy? *

Degree (B. Pharmacy)

Diploma (D. Pharmacy)

Other

Required

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of K.K.Wagh Education Society, Nashik. Report Abuse