TAMIL NADU PHARMACY COUNCIL

Application for Good Standing Certificate

1. Name in Full

2. Father’s Name

3. Date of Birth

4. Registration Certificate No & Date

5. Present Address

6. Local Contact Address

With Phone No.

7. Contact E-Mail Address

8. Qualification

9. Month & Year of Passing

10.Institution

11.Name of University

12.Name & Address of Board to which

the Good Standing Certificate to be sent

Place:
Date: Signature
Enclose:
1. Two Copies of Registration Certificate issued by the Council
2. Two Copies of Additional Qualification/s, if registered
2. Postal Stamps to a Value of Rs.100/-
3. Fees Rs.2000/- by Demand Draft Favoring “ The Registrar Tamil Nadu Pharmacy Council, Chennai”
4. A copy of Degree/UG Certificate/s.