INSTITUTE OF PHARMACY & RESEARCH Anjangaon Bari Road, Badnera-Amravati

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Admission Enquiry Form 2025-26

Email *

1. Title(Mr./Ms./Mrs.) *

2. First Name *

3. Father's Name/Husband's Name *

4. Surname *

5. Mother's Name *

6. Gender *

Male

Female

7. Date of Birth *

YYYY

8. Category *

VJ/DT

OBC

EWS

Minority

General

9. Validity Certificate available(Y/N) *

Yes

10. Whether claiming any concession(Y/N) . If yes under what category *

11. Address for communication *

12. Contact No.(Father/Mother) *

13. Student Contact No.(What'sApp) *

Record of Academic Career

14. B. Pharm Year of Passing *

15. B.Pharm Percentage (Pointer) *

16. Whether Qualified GPAT *

17. 16. Whether Qualified NIPER

18. Percentile of GPAT *

19. Percentile of NIPER if qualified (Write NA if not appeared or qualified)
*

20. Interested in the course *

M.Pharm. (Pharmaceutics)

M.Pharm. (Pharmaceutical Chemistry)

M.Pharm. (Quality Assurance)

21. Would you like to join Institute what'sApp group for Admission information *

Yes

22. Link to join WhatsApp group

Submit

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