ADMISSION ENQUIRY TO PHARMACY COURSES FOR THE ACADEMIC YEAR   2025-2026
Sign in to Google to save your progress. Learn more
Course *
Name  *
as per your SSLC certificate 
Gender  *
Date of Birth  *
as per your SSLC/ equivalent certificate
MM
/
DD
/
YYYY
Address *
Contact Number 1 *
Contact Number 2 *
Email ID *
HSE or Equivalent *
Required
Have you applied for the KEAM 2025 examination for the Pharmacy course
Clear selection
Are you qualified in KEAM 2025
Clear selection
Next
Clear form
Never submit passwords through Google Forms.
This form was created inside of jamia salafiya pharmacy college.

Does this form look suspicious? Report

Google Forms