Haneefa Institute
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Online Application Form
Fill in the details below to apply for admission at Haneefa Institute
Personal Information
First Name
*
Last Name
*
Date of Birth
*
Gender
*
Male
Female
Other
Father's Name
*
Mother's Name
*
Nationality
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Category
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Select Category
General
OBC
SC
ST
Other
Contact Information
Email Address
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Phone Number
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Alternate Phone Number
WhatsApp Number
Permanent Address
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City
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State
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PIN Code
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Country
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Course Information
Select Course
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Select a Course
Diploma in Medical Lab Technology
Diploma in Radiology Technology
Diploma in Operation Theatre Technology
Diploma in Physiotherapy
Diploma in Dental Hygienist
Diploma in Emergency Medical Services
Diploma in Fire & Safety Engineering
Industrial Safety Management
Construction Safety Management
Hazardous Material Handling
Diploma in Hotel Management
Diploma in Culinary Arts
Front Office Operations
Food & Beverage Service
Academic Year
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Select Year
2024-2025
2025-2026
Preferred Mode of Study
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Select Mode
Full Time
Part Time
Educational Qualification
10th Standard Board
*
10th Percentage/CGPA
*
10th Year of Passing
*
12th Standard Board
12th Percentage/CGPA
12th Year of Passing
Any Other Qualifications
Documents Upload
Please upload scanned copies of the following documents (PDF/Image format, Max 2MB each)
10th Marksheet
*
Choose File
12th Marksheet
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Identity Proof (Aadhar/PAN)
*
Choose File
Passport Size Photo
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Choose File
Additional Information
How did you hear about us?
Website
Social Media
Friend/Relative
Newspaper/Advertisement
Other
Any Additional Information or Questions
I hereby declare that all the information provided by me is true and correct to the best of my knowledge.
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I agree to the terms and conditions of Haneefa Institute.
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