Registration |
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Required Information
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Referral's Name : |
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*Referral's College : |
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*Referral's State :
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Candidate Type : |
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*Package Name :
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Fees :
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*Name :
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Birth Date :
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Gender :
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*Address :
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(Kindly
provide your permenant address for ensuring that the payment reaches you
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Country :
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State :
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City :
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Pin Code : |
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Phone No.:
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* Mobile :
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Education Details
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*Current Status :
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*Institute :
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*Current Occupation :
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Personal Details
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Married/UnMarried :
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*How did you come to know :
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Payment Info :
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* Payment Mode :
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Bank Name :
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Branch Name :
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Drawee Bank :
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Branch :
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Cheque/DD No. :
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Please confirm your payment by sending a mail to [email protected] and do SMS on
mobile No. : 9825005840, immediately after making the payment to the Bank, if
possible by attaching a scanned image of the bank receipt |
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