Counselling Registration
Dear Candidate

This form is to keep a record of the sessions given and related concerns.Please note that no name or personal details will be shared with anyone.
Email *
1. Name *
2. Age (In years) *
3. Mobile No. *
4. Class(if in school)/ College years/ Working Sector *
5. emailid *
6. Gender
Clear selection
7. City & State
8. Your concern
Clear selection
9. Please specify the concern/issue
10. Preference of mode of Session *
11. Choose a Date for Session *
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12. Choose a time slot to book your appointment. While we try to keep the preferred date & time by you, the final appointment will depend on on the availability of the counselor. *
13. Are you interested in Psychometric Testing for knowing more about yourself? *
14. Are you interested in taking a package based Career Guidance? *
Thank you for your booking. Have a wonderful day!
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