BPB Specimen Request Form
Name *
Academic Designation (Principal/HOD/Librarian/Assistant Professor/Professor or any other) *
Email ( Official ) *
Email 1
Mobile *
Mobile 1
Landline Phone
Institute / University / College Name *
Institute/ University / College Address *
Institute/ University/ College Pin Code *
Book Title *
Book ISBN
Course Name
Subject
Semester
Student's Strength
Will you be interested in writing a book/Review a book
Specify subjects of your interest
Best time to contact
Existing book used
Message / Feedback to BPB
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