RL Institute of Pharmacy

Personal Details

Academic Details

Program Selection

Document Upload

Payment

👤 Personal Information

Full Name *

Date of Birth *

Gender *

Category *

Email Address *

Mobile Number *

Address *

City *

State *

Pincode *

📚 Academic Information

10th Standard Details

Board Name

Passing Year

Percentage / CGPA

Roll Number

12th Standard Details

Board Name

Passing Year

Percentage / CGPA

Roll Number

Physics Marks

Chemistry Marks

Biology/Mathematics Marks

Graduation Details (For Ph.D. Applicants)

Bachelor's Degree

University Name

Passing Year

Percentage / CGPA

🎯 Program Selection

Select Program *

Preferred Counseling Mode

Preferred Counseling Date (Optional)

📎 Document Upload

Please upload clear scanned copies of the following documents (Max size: 2MB each, Format: JPG/PNG/PDF)

Recent Photograph

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Click to upload passport size photo

No file chosen

Signature

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Click to upload signature

No file chosen

10th Marksheet

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Click to upload 10th marksheet

No file chosen

12th Marksheet

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Click to upload 12th marksheet

No file chosen

Caste Certificate (if applicable)

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Click to upload caste certificate

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Aadhar Card

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Click to upload Aadhar card

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💰 Application Fee Payment Details

Application Summary

Application Fee: ₹1,000

Processing Fee: ₹200

Total Amount: ₹1,200

Bank Account Details for Payment

Bank Name: Central Bank of India

Account Name: R L Institute of Pharmacy

Account Number: 5477084595

IFSC Code: CBIN0285122

Account Type: Current Account

📌

Important Instructions:

Make payment of ₹1,200 via NEFT/RTGS/IMPS/UPI using above bank details
After payment, enter the Transaction ID/Reference Number below
Upload payment screenshot/proof for verification
Your application will be processed after payment verification

Payment Confirmation Details

Transaction ID / Reference Number * Example: SBIN1234567890 or UPI Ref: 123456789012

Payment Date *

Payment Mode *

Amount Paid *

Payment Receipt / Screenshot *

💰

Click to upload payment screenshot or receipt

No file chosen

Accepted formats: JPG, PNG, PDF (Max: 2MB)

I hereby declare that all the information provided in this application form is true and correct. I have made the payment of ₹1,200 and the transaction details provided are accurate.

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Apply Online for Admission 2024-25

👤 Personal Information

📚 Academic Information

10th Standard Details

12th Standard Details

Graduation Details (For Ph.D. Applicants)

🎯 Program Selection

📎 Document Upload

💰 Application Fee Payment Details

Application Summary

Bank Account Details for Payment

Payment Confirmation Details

Why Apply Online?

Quick & Easy

Secure Process

Track Status

24/7 Support

Need Help With Application?

Apply Online for Admission 2024-25

👤 Personal Information

📚 Academic Information

10th Standard Details

12th Standard Details

Graduation Details (For Ph.D. Applicants)

🎯 Program Selection

📎 Document Upload

💰 Application Fee Payment Details

Application Summary

Bank Account Details for Payment

Payment Confirmation Details

Why Apply Online?

Quick & Easy

Secure Process

Track Status

24/7 Support

Need Help With Application?

Admission Application Form