Course Registration Form

Personal details

First Name	Enter your name
Surname	Enter your surname
Mobile number	Enter your mobile number
Email	Enter your email
Password	Enter a strong password
Confirm Password	Confirm your password
DOB	Enter your date of birth
AGE	Enter your age
Gender Select your gender	Male Select your gender Female Select your gender Others Select your gender
Select Country	Select your country
Upload Picture	Upload your photo

Course Details Select Course

Select your preffered course

Delivery Mode ONLINE

Select your preffered course mode

OFFLINE

Select your preffered course mode

INSTITUTE NAME

Choose your present Coding knowledge level:

Comments