Application Form
A Promising Future by AICP
Step 1 of 4
Step 1: Personal Information
Student Name
Please enter your name.
Date of Birth:
Please enter your date of birth.
Gender:
Select
Male
Female
Other
Please select your gender.
Phone:
Please enter a valid 10-digit phone number.
CNIC:
Please enter a valid 13-digit CNIC.
Email:
Please enter a valid email address.
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Step 2: Location and Demographics
Country:
Please enter your country.
City:
Please enter your city.
Address:
Please enter your address.
Religion:
Please enter your religion.
Caste:
Please enter your caste.
Age:
Please enter your age.
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Step 3: Educational Background
Previous Education Name:
Please enter the name of your previous education.
Total Marks:
Please enter the total marks.
Obtained Marks:
Please enter the obtained marks.
Select Course:
Select
Doctor of Pharmacy (Pharm-D)
Please select a course.
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Step 4: How did you find us?
Referral Source:
Select
YouTube
Facebook
Google Ads
Website
Newspaper
Brochure
Family / Friends
Banners
Box Board
Hoarding Board
Seminar
TV
SMS
Please select a referral source.
Other
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