|
INSTITUTIONAL / GROUP ONLINE REGISTRATION FORM
|
INSTITUTIONAL / GROUP DETAILS
|
Institution Name*
|
|
Order ID*
|
|
Address*
|
|
State*
|
|
City*
|
|
Pin/Zip Code*
|
|
Citizen*
|
|
EmailID*
|
|
Tel*
|
|
|
*Invoice would be raised as per the above details
|
INSTITUTIONAL / GROUP PERSON CONTACT DETAILS
|
First Name*
|
|
Last Name*
|
|
Designation*
|
|
Address*
|
|
State*
|
|
City*
|
|
Pin/Zip Code*
|
|
Citizen*
|
|
EmailID*
|
|
Tel*
|
|
INSTITUTIONAL / GROUP PAYMENT DETAILS
Please note AAFM India accepts payment from all Bank Debit and Credit Cards except American Express Cards .
Please select PayTm in case you wish to make payment through netbanking or else select ICICI gateway.
|
Certification Type*
|
|
|
|
Login ID*
|
|
Password* |
|
Select Paymemnt Gateway*
|
|
Base Amount*
|
|
Processing Fees*
|
|
Total Amount*
|
|
Payment Remarks*
|
|
|
|
|
|
|