Application for Admission

Begin your journey to becoming a medical professional. Complete the form below to submit your application to the PLT College of Medicine.

Program Selection

Requested Program *

First Name *

Middle Name

Last Name *

Birthdate *

Gender *

Civil Status

Nationality *

Complete Address *

Email Address *

Phone Number *

Guardian Name

Guardian Contact Number

High School

School Name *

Year Completed *

College (if applicable)

Course/Degree

Year Completed

Year Taken *

Month Taken *

NMAT Score *

Please review all information carefully before submitting. You will receive a confirmation email with your application reference number.