demo form 19

First Name *

Last Name *

Email *

Gender *
MaleFemalePrefer not to say

WhatsApp Mobile Number *

Parents Mobile Number *

City *

State *

Course *
SelectBoth Module (New Syl - 7 Subjects)Module 1 (New Syl - 4 Subjects)Module 2 (New Syl - 3 Subjects)Single SubjectAll 3 Module (Old Syllabus)Module 1 (Old Syl)Module 2 (Old Syl)Module 3 (Old Syl)Module 1 & Module 2 (Old Syl)Module 2 & Module 3 (Old Syl)Module 1 & Module 3 (Old Syl)

If Any Single Subject (for example, Tax)

Syllabus Type *
New SyllabusOld Syllabus

Type of Admission *
New AdmissionRemaining FeesValidity Extension

Mode of Class *
Online RecordingLive + RecordingFace To Face Batch

Payment to________Account (Account Holder Name) *

Total Fees *

Paid Fees *

Counsellor Name (For Eg. Office) *

Add Your Photograph *

Add Signature (Upload your signature) *

Payment Method *
OnlineCash

Transaction Date *

Upload Payment Receipt *

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