IIBMS BUSINESS SCHOOL
Name
*
:
Branch Name
*
:
Counsellor Name
*
:
Phone Number
*
:
Courses Details
*
:
Pay Amount
*
:
Currency
*
:
Select
INR
USD
Transaction Type
*
:
Select
New Enrollment
Pending Amount
Comment
*
:
Billing information
Address
*
:
City
*
:
State/Province
*
:
Zip/Postal Code
*
:
Country
*
:
Select
Email
*
:
*Note:
All the fields mark as (
*
) are mandatory.