Application Form

WNHO INSTITUTE OF COSMETOLOGY & SKIN,PUNE, INDIA

                                                                     Date

                        Cosmetology & SKIN Therapy Course & Skill Empowerment.

Under Govt. Recognized Startup DIPP No.3274.

Dear Sir,

I would like to enroll for the above course. I enclose Bank Draft/DIGITAL PAYMENT No. …………………. drawn on ……………………………………………………… in favor of WNHO Healthcare Pvt. Ltd. Pune for COSMETOLOGY & SKIN Fellowship/PG Diploma course further fees Rs. 50,000/ is deposited

I give below the information requested by you.

(Please use block letters and tick wherever applicable)

1. Name in full (surname first): ……………………………………….……………………………..
2. Sex:          Male (   )       Female  (   )
3. Mailing address: …………………………………………………………………………………………....

…………………………………………………………………………………. Pin Code ……………………….

Tel. Nos. Mobile ……………………..….  Res…………………………… Clinic……………………

email: ………………………………………………………………………….................................

4.         Qualifications: …………………………………………………Reg.No……………………………

5.         Registration No./Date ……………………… State …………………………….................

6.         I practice as:  Family Physician (   ), Consultant (   ), others ……………………………..

7.         My special interest is …………………………………………………………….......................

8.         I have attended: Cosmetology Training Programmed (   ), Seminars (   ), Workshops (   ), No previous exposure (   ). I understand this is purely a correspondence course dealing with the essentials on cosmetology & Skin  concerns and problems seen in routine practice. It will be covered in eight sessions in approximately Nine months.

 Yours faithfully,

       Signature

Please mail with 

Demand Draft in favor/ Ban transfer  of WNHO Healthcare Pvt. Ltd. HDFC Bank RTGS/NEFT IFSC : HDFC0000962. Payable Pune Bibvewadi Branch.

Registered Office Director-Dr. Ramesh Mahshwari, Wnho Health Care Pvt.Ltd. Web www.wnhohealthcare.com/www.sexologyinstitute.co.in.

2014 Sadashiv Peth, Dhanvantari Building, Office no.-3,

Tilak Road, Opposite ICICI Bank,Pune Pin Code 411030

Ph. 020 24463540 / 9822006427

Please enclose: 

• Photocopies of Degrees and Registration Certificate
• Self Attested passport size photograph