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.

Payment For*

Login ID*

Password*

Select Paymemnt Gateway*

Base Amount*

Processing Fees*

Total Amount*

Payment Remarks*