Admission Form

Account No	Bank Name
1200035977115	1664-CANARA CA TRUEDGE

IZMA PHARMA TRAINING INSTITUTE ADMISSION FORM

1. Student Information

Full Name:

Father’s/Guardian’s Name:

Date of Birth:

Gender:

Nationality:

Mobile Number:

Email ID:

Aadhaar Number (Optional):

2. Correspondence Address

Address:

City:

Pin Code:

State:

3. Academic Qualifications

Qualification	Board/University	Year of Passing	Percentage/CGPA
SSC/10th
HSC/12th
Diploma
Graduation
Post-Graduation

4. Course Details

Course Applied For:

Preferred Batch:

Admission Date:

5. Emergency Contact

Name:

Relationship:

Contact Number:

6. Supporting Documents

Please upload the required documents:

☐ Recent Passport-size Photo (2 copies)
Photo ID Proof (Aadhaar/Driving License)
Last Qualification Marksheet
Address Proof
Any Experience Certificate (if applicable)

7. Declaration

I declare that all the information provided is true to the best of my knowledge. I understand that my admission may be cancelled if any detail is found incorrect. I agree to follow the institute rules and regulations.

Signature Upload:

Date:

8. Payment Screenshot

Please upload the payment screenshot (Mandatory):

Reliable Drug Testing Starts Here

About Us

At IZMA, we specialize in certified testing services across pharmaceuticals, water, cosmetics, and chemicals. Our commitment to precision, speed, and regulatory compliance makes us a trusted partner for quality assurance.