New Applicants



Online Submission Form
Title *
Name *
Type of membership applied *
Annual (Rs. 2,000)
Student (Rs. 1,000)
Life Time Membership (Rs. 20,000)
Date of birth *
Designation/Occupation *
Name of organization/institution *
Work address *
Home address *
Home number *
Mobile number *
Email ID *
Receive SMS alerts from PSM *
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Blood group
Drug allergies
Name of contact person in case of emergency *
Contact person's relationship to self *
Contact person's mobile number *
Upload your scanned passport size photograph *
(.jpg, .gif, .png)
Upload the screen-shot of your payment *
(.jpg, .gif, .png)
Verification Code * (Click to refresh image)
* mandatory field