Registration Form You are requested to go through our Refund Policy Statement, and Terms and Conditions before filling the below form. Registration Form(Please Fill in this form after you have made the payment) Name Email Full Address with PINCODE Contact Number Birthday Mother tongue Your Current Profile Select School Student College Student Employed ( 1 - 3 Years Experience ) Employed ( 4+ Years Experience ) Self Employed ( 1 - 5 Years Experience ) Self Employed ( 5+ Years Experience Home Maker Unemployed Others Qualification Status Select High School Higher Secondary Under Graduate (Pursuing) Graduate / Diploma Post Graduate Research / Ph.D Others Registered Course Select Fluency Mastery Course Base Plan (3 Months) Fluency Mastery Course Stellar Plan (3 Months) Business English (5 Months) Unlock - Self Learning Portal Access Classroom / Hybrid Learning (3-Month) Empower (4 Months) British Council-Aptis Exam Preparation + Certification British Council-Aptis Exam Certification V Test Certification One to One Pay as You Go - A1-B1 One to One Pay as You Go - B2-C1 Other Courses Course Fee Paid Amount Due Amount Mode of Payment Bank Transfer / Deposit Gpay /PayTM/ Phonepe Cash POS Swiping Machine Cheque Razorpay Payment Gateway How did you come to know about Aksent? Select Google Maps & Reviews I found you on Google Ads Just Dial / Sulekha Facebook / Instagram Reference (Please mention the referrer name in Remarks) Was a student of Aksent Saw your Banner Ad on the internet Others Remarks Why did you choose Aksent? (Choose only THREE best option) Course Curriculum Approach of the Counsellor Training Experience Trainers' Profile Flexible Batch Timing Reviews and Feedback Our Advertisements I agree to the Refund Policy and T & C. I have gone through the same Accept by checking the box Submit the Form
