IEMA Winter School Registration Form

Instructions :

Please read the instructions carefully and fill up all relevant sections before submitting the form.
Improperly filled up forms will not be considered.
Students must have a valid e-mail id to register.
After submission, a copy of the form will be mailed to you at your e-mail id.
Email address *
Program *
First Name *
Your answer
Last Name *
Your answer
Gender *
Email *
Your answer
Phone No *
Your answer
Highest Qualification *
College/School *
Your answer
Enter NEFT Transaction ID *
Your answer
Date of Transaction *
MM
/
DD
/
YYYY
Bank Name *
Your answer
Branch Name *
Your answer
Enroll the Course *
A copy of your responses will be emailed to the address you provided.
Submit
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