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First Name
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Last Name
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Email
*
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Mobile
*
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Gender
*
Select Gender
Male
Female
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Date of Birth
*
Father Name
*
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Father Mobile No.
*
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Passport Size photo
*
Signature Photo
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Course
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Stream
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Class Program
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Center
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Select Exam Centre
Agra
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Correspondence Address
Address
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Land Mark
*
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City
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State
*
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Postal Code
*
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PERMANENT ADDRESS
Same as correspondence address
Address
Land Mark
*
City
*
State
*
Postal Code
*
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PERSONAL DETAILS
First Name
*
{{registerData.user.firstName}}
Last Name
*
{{registerData.user.lastName}}
Email
*
{{registerData.user.email}}
Mobile
*
{{registerData.user.mobile}}
Gender
*
{{registerData.user.gender}}
Date of Birth
*
{{registerData.user.dob}}
Father Name
*
{{registerData.user.father.name}}
Father's Mobile
*
{{registerData.user.father.mobile}}
Correspondence Address
Address
*
{{registerData.user.address.address}}
Landmark
*
{{registerData.user.address.landmark}}
City
*
{{registerData.user.address.city}}
State
*
{{registerData.user.address.state}}
Postal Code (PIN)
*
{{registerData.user.address.postalCode}}
Permanant Address
Address
{{registerData.user.permanentAddress.address}}
Landmark
{{registerData.user.permanentAddress.landmark}}
City
{{registerData.user.permanentAddress.city}}
{{registerData.user.permanentAddress.state}}
Postal Code (PIN)
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PHOTOS
Passport Size photo
*
Signature photo
*
Course
*
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Stream
*
{{streams[registerData.stream].valueAlias}}
Session
*
2018-19
Classroom Program
*
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Confirm & Next
Program/Product
Session
Total Amount
{{selectedProduct.title}}
2018-19
{{products[registerData.productIndex].cost}}
Payment Details
Payment Method:
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Online (Net Banking or Debit/Credit Card or UPI or Wallet)
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Discount:
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Payable Amount:
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