Online Application Form - Al Salama Eye Hospital Kerala

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info@alsalama.org

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Al Salama College of Optometry, Perinthalmanna, Malappuram 679322

(Affiliated Kerala University of Health & Allied Science, Thrissur)

Online Application for admission to Bachelor of Optometry (B Optom) during the academic year 2026-2027

Full Name as in SSLC *

Application Qouta *

Name of the Guardian & Relation *

Occupation of Guardian *

Gender* MaleFemale

Date of Birth*

Nationality *

Religion, Caste *

Social Status * Persent Address * Permanent Address *

Contact Number *

Email *

Guardian Number *

State * District * Details of qualifing examination passed

Name of the Course

Group/Major

Institution

Year of Passing

Percentage of Mark

Name of the Course

Group/Major

Institution

Year of Passing

Percentage of Mark

Upload SSLC Certificate *

Upload Plustwo Mark List *

Upload Photo *

Terms and Conditions * I here by declare that the particulars given above are correct. If any particulars given are found to incorrect at any point of time; i will, if admitted, abide by the rules and regulations of the university.

Sign *

Date-Time of Submission

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