Alert
×
Sorry Prateek Jaiswal for new Joining total Amount should be more than or equal to
1100
Please add more Items to Continue.
Self Registration Application
Name
What's your name?
Gender
Select
Male
Female
Your Gender is invalid
Date of Birth
Date of Birth is required
Occupation
Occupation is required
Mobile No
Mobile No is required
WhatsApp Mobile No
WhatsApp Mobile No is required
Address
Address is required
Pincode
Pincode is required
City
SELECT
AGRA
AHMADABAD
ALLAHABAD
AMBEDKAR NAGAR
AMETHI
ARARIA
ASANSOL
AZAMGARH
BAHARAICH
BAKUDA
BALIA
BALRAMPUR
BANDA
BANGALURU
BANKURA
BARABANKI
BARELY
BASTI
BEGUSARAI
BHABHUA
BHADOHI
BHAGALPUR
BHATNI
BHILAI
BHIND
BHOPAL
BIHAR
BINDKI
BIRBHUN
BULANDSAHAR
BURADWAN
BURDMAN
BURDWAN
BUXAR
CHANDAULI
CHANDIGARH
CHHATTISGARH
CHHIBRAMAU
CHUNAR
DAGA BARGAWAN
DELHI
DELHI-31
DEORIA
DHANBAD
DHARAMSHALA
ETAWAH
FAIZABAD
FARIDABAD
FATEHPUR
GARHWA
GAZIABAD
GEEJAPUR
GHAZIPUR
GONDA
GOPALGANJ
GORAKHPUR
GURGAON
GUWAHATI
GWALIOR
HANUMANGARH TOWN
HAPUR (U.P)
HARDOI
HARIDWAR
HOWRAH
HYDERABAD
JALOUN
JAMNAGAR
JAMSHEDPUR
JARWAL
JAUNPUR
JHAJJAR
JHANSI
JOUNPUR
KAISERGANJ
KANPUR
KAUSAMBI
KHALILABAD
KHUSHINAGAR
KODERMA
KOLKATTA
KONCH
KOSAMBI
KOTA
KUSHINAGAR
KUSINAGAR
LAKHIMPUR KHERI
LUCKNOW
MADHUBANI
MAHARAJGANJ
MAHDWAL DIST.
MAHMOORGANJ
MAINPURI
MAJDIA
MATHURA
MAU
MEERUT
MEHRAJGANJ
MIRZAPUR
MORADABAD
MOTIHARI
MUGALSARAI
MUJJAFARPUR
MUMBAI
NAGPUR
NAINITAL
NALANDA
NANPARA
NAWALPUR
NEW DELHI
OTHER
PALAMU
PATNA
PATNA CITY
PRATAPGARH
PUNE
RAMAPUR
RAMPUR
RANIGANJ
RATLAM
REHLA
ROBERTSGANJ
RUDRAPUR
SAGAR
SAHABAJGANJ
SALANPUR
SAMASTIPUR
SANT KABIR NAGAR
SASARAM
SHRAWASTI
SIDDHARTHA NAGAR
SITAPUR
SIWAN
SONBHADRA
SONEBHADRA
SULTANPUR
SURAT
SURGUJA
TITAGARH
UNNAO
UTRAULA
VAISHALI
VARANASI
VISHAKAPATTNAM
VIZAG,VISHAKAPATTNAM
Other
City is required
State
SELECT
Andaman Nicobar
Andhra Pradesh
Arunanchal Pradesh
Assam
Bihar
Chhattisgarh
Goa
Gujarat
Haryana
Himachal Pradesh
Jammu and Kashmir
Jharkhand
Karnataka
Kerala
Madya Pradesh
Maharashtra
Manipur
Meghalaya
Mizoram
Nagaland
New Delhi
Orissa
Punjab
Rajasthan
Sikkim
Tamil Nadu
Tripura
Uttar Pradesh
Uttaranchal
West Bengal
State is required
Nomaniee Information
Nomaniee Name
What's your Nomaniee Name?
Relationship
Select
Mother
Father
Wife
Sister
Brother
Husband
Other
Your Relationship is invalid
Date of Birth
Date of Birth is required
Bank Information
Bank Name
What's your Bank Name?
Branch
What's your Bank Branch?
A/C No.
What's your A/C No.?
IFSC
What's your Bank Account IFSC?
Other Information
PAN
What's your PAN?
Aadhar No.
What's your Aadhar No.?
GSTIN
What's your GSTIN?
Sponsor Information
Sponsor ID
I hereby declare that the information provided is true and correct
You must agree with our Terms and Conditions
Submit
Cancel
