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IIHMCA Online Application Form
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( Affix latest Passport size Colour Photograph)
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Instructions
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Read the application form carefully before you fill it.
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Please use ( √ ) tick mark in appropriate boxes wherever required.
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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.
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All Information you provide will only be used by our Admission
Department and will remain strictly confidential.
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Personal Details
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Name of the Student
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DOB & Age
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Father’s Name
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Address
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Email
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Course
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Phone Number
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Educational Qualifications
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Additional Qualifications
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How did you get to know about IIHMCA?
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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.
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