Shaheed Sheikh Bhikhari College of Education, Sutiyamble, Kanke, Ranchi (Jharkhand) is established and managed by PRSNM Charitable Trust for Human Welfare. It is recognized by NTCE Bhubaneswar under Ranchi University to provide education in B.Ed Course to the Students both boys and girls at ssbce.in

APPLICATION FOR REGISTRATION

1. Name (as on Mat. Cert.) :

2. Date of Birth :

3. Age :

4. Height (cm) :

5. Weight (kg) :

Photograph

6. Religion :

7. Culture Background :

8. Permanent Address :

9. Present Address :

10.

Educational Qualification	Total Marks	Year of passing	Division	% of Marks	Certificate
a. Matric
b. I.Sc./I.A./I.Com.
c.

11. Father's Name :

12. Age :

13. Occupation :

14. Mother's Name :

15. Age :

16. Occupation :

17. Guardian's Name if Applicable :

18. Relationship :

19. Occupation :

20. Address :

21. Local Guardian's Name, if Applicable :

22. Relationship :

23. Occupation :

24. Address :

25. Reasons for selecting Nursing as a carrier :

26. Contact Details :

Landline :

Mobile :

E-mail :

DECLARATION

I hereby declare that the statements given in the application are true, and I agree to follow the rules and regulations of the institution subject to change from time to time.

*** Please check the required fields in the registration form.