PBMS

Applicant Name *

Father's Name *

Examination Name *

Have written the exam and qualified for higher studies?

Yes

No

Year of writing the exam and qualifying for higher studies*

Register Number for writing the exam and qualifying for higher studies*

Name of the institution to which the applicant intends to study*

The state in which the applicant intends to study*

Address Lane 1*

Address Lane 2

District*

PIN Code*

Mobile No.*

Upload the attested copy of the certificate by the head of the school *

Choose file... File should be in pdf format and maximum allowed size is 100kb