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Alumni Registration Form

Title*

Surname*

Firstname*

Upload relevent Proof*

Upload relevant proof for PGI alumnus identification(ID card/Degree copy etc. (JPG,PNG,GIF,PDF only))

Username*

Password*

E-mail / Login ID*

Payment Transaction Date*

Payment Transaction ID*

Please provide the Transaction ID of your payment.

Payment Amount*

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I agree to the Eligibility rules of the membership

Payment Instructions

INR 500 for Indian Residents and residents of other SAARC countries.

USD25 for all others.

Bank details are-
State Bank of INDIA, MEDICAL INSTITUTE branch
Account No.39103473905
Account Name. PCAAS
IFSC CODE-SBIN0001524
MICR CODE 160002007
SWIFT CODE SBININB B443

Alumni Registration Form

Payment Instructions

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