Online Admissions

    IIHMCA Online Application Form ( Affix latest Passport size Colour Photograph)

    Instructions

    • Read the application form carefully before you fill it.
    • Please use ( √ ) tick mark in appropriate boxes wherever required.
    • The application form will be attended only if all the required information is included. Please re-check form to ensure you have not left any data un-filled.
    • All Information you provide will only be used by our Admission Department and will remain strictly confidential.
     
    Personal Details
    Name of the Student :
    Date of Birth and Age :
    Father's Name  
    Mother's Name  
    Address  
    Telephone Number  
    		 
    Email Address of the Candidate  
    Aadhar Number of the Candidate  
    Course :
    Educational Qualifications
    Examination Passed Name of the Institute Studied Group Year of Passing % Marks Percentage Remarks
    Additional Qualifications
    Fluency in English : ExcellentAverageBelow Average
    Other Languages Known to Speak / Read / Write  
    Family BAckground
    Relation Ship Name Occupatoin & Designation Contact Phone Number
    Father
    Mother
    Brother / Sister
    Extra Curricular Activities and Certificates / Prizes Won
    		 
    Additional Information you wish to give
    How did you get to know about IIHMCA? :
    		 
    *Specify :

    Declaration by Applicant:

    I declare that all information in my application is complete, factually correct and honestly presented. I have read the rules and regulations mentioned in the admission brochure and will adhere to the same. I also understand that fees once paid will not be refunded under any circumstances.
    Date :
    		 
    Place :
         
    *After you submit the form you will be prompted to make the payment.
     
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