Scribd
Upload
242 views5 pages

Application Form For Mbbs Program: Kathmandu University

1) The document appears to be an application form for admission to the MBBS program at Kathmandu University School of Medical Sciences. 2) It requests information such as personal details, education history, and a declaration signed by both the applicant and parent/guardian. 3) Instructions are provided regarding the documents required, application process, and entrance exam for admission eligibility.

Uploaded by

Trilok Shrivastava
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
242 views5 pages

Application Form For Mbbs Program: Kathmandu University

1) The document appears to be an application form for admission to the MBBS program at Kathmandu University School of Medical Sciences. 2) It requests information such as personal details, education history, and a declaration signed by both the applicant and parent/guardian. 3) Instructions are provided regarding the documents required, application process, and entrance exam for admission eligibility.

Uploaded by

Trilok Shrivastava
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 5

Seat No.

_______

APPLICATION FORM
for
MBBS PROGRAM

KATHMANDU UNIVERSITY
SCHOOL OF MEDICAL SCIENCES
DHULIKHEL
CHECKLIST FOR DOCUMENTS TO BE ENCLOSED (xerox copies only)

Mark sheet of the qualifying examination and other transcripts


Birth certificate or an examination certificate or character certificate showing date of
birth
Photographs, 3 passport size
Citizenship Certificate.

General Instructions

1. Applicants must complete the application form with their recent passport size
photograph.
2. Applicants should submit completed application along with the bank voucher of Rs.
3000/- to Dean's office, School of Medical Sciences, Dhulikhel Hospital, Dhulikhel
3. Copies of original transcripts (high school onwards), birth certificate or character
certificate showing the date of birth & citizenship certificate should be submitted along
with the application form.
4. Applicants who do not appear in the Entrance Test conducted by the University will not
be eligible for admission.
________________________________________________________________________

Correspondence

All correspondences relating to admissions should be addressed to:

Kathmandu University, School of Medical Sciences


Dhulikhel Hospital, Dhulikhel
P.O. Box 11008
Kathmandu, Nepal

Tel # : (011) 490497


Fax # : 977 11 490777
KATHMANDU UNIVERSITY
SCHOOL OF MEDICAL SCIENCES

Application for the MBBS Program


(To be filled in by the applicant in block letters)
Admission sought for the academic year _________

For office use only Form No.: _______


Date received _____________________________

Document checklist I.Sc. or 10+2 SLC Cha.C CC BV Passport size


B.Sc. photograph to be
PCBE marks % ___________________________ attached here
Aggregate marks % ________________________
Remarks _________________________________
Cha.C= Character Certificate, CC = Citizenship Certificate, BV= Bank Voucher

GENERAL INFORMATION
1. Name _________________________________________________________________
surname first name other name(s)

2. Sex male female

3. Date of birth ________/_________/__________


day month year (A.D.)
4. Place of birth ____________________________________________________________
town/village district country
5. Name of a) father ___________________________________________________________

b) mother __________________________________________________________

6. Name of guardian (if other than father) ________________________________________

7. Relationship of guardian to applicant __________________________________________

8. Address for correspondence _________________________________________________

________________________________________________________________________

________________________________________________________________________

9. Phone (R) __________________ (O) __________________ Fax _________________

10. Permanent address ________________________________________________________

_______________________________________________________________________

11. Citizenship ______________________________________________________________


EDUCATION

12. List all schools and colleges/Universities attended


Institution Address Date attended
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________

13. Qualifying examination I.Sc. 10+2 or equivalent

Examination Year Marks


Subjects letter grade percentage

I.Sc Physics _____________________________

10+2 Chemistry _____________________________

A Level Biology _____________________________

English _____________________________

PCBE aggregate % _________________________

Total aggregate % _________________________

14. Have you taken courses at KU before? Yes No


If yes, please indicate (a) Course _____________ (b) Registration No. __________

15. Declaration by applicant


I wish to apply for admission to the KU and affiliated Medical Colleges under KU. I declare that to the best of
my knowledge and belief, the above particulars are true. I agree that registration of this application does not
confer any right on me in respect of selection for admission, which was solely left to the discretion of the
university and college. I have gone through the instructions for admission carefully, and I undertake to abide by
all the conditions. I further agree, if admitted, to confirm to the rules and regulations at present in force or that
may hereafter be made for the administration of the university and college. I undertake that so long as I am
student of the college, I will not do anything unworthy of a student of the college of anything that will interfere
with its orderly working and discipline. I am aware that the management has the full authority to take action,
including expulsion for disinterest in studies, misbehaviour and frequent failure.

Applicant's signature ______________________ Date _____________________

16. Declaration by parent/guardian


I hereby declare that I am aware of the financial obligations of applying to and studying at the MBBS Program
and I can afford and undertake to pay the tuition and other fees payable to the institution under its rules. I also
affirm and endorse the declaration made above by my ward.

Signature of parent/guardian _______________________ Date _______________


KATHMANDU UNIVERSITY
Undergraduate Program
MBBS PROGRAM
KUMET – 2010
Admit Card

Name of the Candidate …………………………………………………

Entrance Test Details:


Seat No. : _________

Date : Saturday, 4 September 2010


Time : 11.00 a.m. to 1.00 p.m.

Venue : -----------------------------------------------------------

(N.B. Please bring this copy at the time of entrance test and submit to the invigilator.)

 ……………………………………………………………………………………………

KATHMANDU UNIVERSITY
Undergraduate Program
MBBS PROGRAM
KUMET – 2010
Admit Card

Name of the Candidate …………………………………………………

Entrance Test Details:


Seat No. : _________

Date : Saturday, 4 September 2010


Time : 11.00 a.m. to 1.00 p.m.

Venue : -----------------------------------------------------------

(N.B. Keep this copy safely. You will have to produce it during your interview at medical college.)

You might also like

pFad - Phonifier reborn

Pfad - The Proxy pFad of © 2024 Garber Painting. All rights reserved.

Note: This service is not intended for secure transactions such as banking, social media, email, or purchasing. Use at your own risk. We assume no liability whatsoever for broken pages.


Alternative Proxies:

Alternative Proxy

pFad Proxy

pFad v3 Proxy

pFad v4 Proxy