All fields marked with * are mandatory.

 Username *
Create a login name that you can remember easily. Should be of minimum 6 characters and contain only letters (a-z) numbers (0-9) and underscore (_).
 Password *
Secure your login with a password of minimum 6 characters containing only letters (a-z) numbers (0-9) and underscore (_). Don't write or store this password anywhere.
 Re-type Password *
Retype & reconfirm the password provided above
Hint Question
Hint Answer
 First Name *
 Last Name
If there is a middle name provide the same before the last name 
 Date of Birth , , (dd,mm,yy) *
 Marital Status
Select your marital status
 Spouse's Occupation  
Has to be provided if marital status selected as "Married".
 No. of Children  
(Provide the ages of children in the adjacent boxes in ascending order)
 Present Home Address
 Bldg./Street *  Area *
 City *  State *
 Pin Code *
 Telephone (O)  Telephone (R) *
 Email id
 Address (Work)
 Bldg./Street  Area
 City  State
 Pin Code
 Address (Permanent)
 Bldg./Street  Area
 City  State
 Pin Code  Telephone (R)
 Educational Qualifications *
 Professional Qualifications: *
 Nursing Specialty:
 Nursing Experience
 Employer  No. of Years  Title  Duties Performed
Whether Passed CGFNS Yes No
Have you attended a course on CGFNS Yes No
Whether Passed TOEFL/TWE Yes No
Whether Passed TSE Yes No
Have you attended courses on TOEFL/TWE & TSE Yes No
Do you have any relations in the US who can accommodate you for 3 months ?
Yes No
 Passport No.
If you have the passport, other related details are compulsory.
 Place of issue
 Date Of Issue (dd,mm,yy)  Valid Up to (dd,mm,yy)
Give a short write up on yourself
(Not less than 50 words and more than 200 words)


Nurses have the following two payment options:-

1. Rs. 20,000.00 upfront. This amount will be refunded to the nurse in the US as soon as she/he is placed in a hospital or health care facility as an RN.

2. US$ 350.00 per month for ten months after a nurse is placed in a hospital or health care facility in the US as an RN.In this option the nurse has to deposit her original documents (as given in the draft MOU) with BhMNS.

Please print the appropriate MOU (depending on your choice of payment option) on a Rs. 20.00 Stamp Paper, sign it, have it witnessed by two witnesses and have it stamped and countersigned by a 1st Class Magistrate or a Notary Public. After this please despatch it by surface mail (preferably by courier) to the BhM Nursing Solutions office address given below.

1. Rupee Payment Option

2. US $ Payment Option

India Office:
BhM Nursing Solutions
No. 3, Great Eastern Summit ‘A’
CBD Belapur, Sector 15
Mumbai, 400614
Tel: 022-27565643 / 27565869. Ask for Mrs. Joyti Shinde;
e-mail:; or