+
+ |
+
+
+ *
+
+ |
+
+
+ {% render_field form.username %}
+
+ |
+
+
+ |
+
+
+ *
+
+ |
+
+
+ {% render_field form.email %}
+
+ |
+
+
+ |
+
+ *
+
+ |
+
+
+ {% render_field form.password %}
+
+ |
+
+
+ |
+
+ *
+
+ |
+
+
+ {% render_field form.confirm_password %}
+
+ |
+
+
+ |
+
+ *
+
+ |
+
+
+ {% render_field form.title %}{% render_field form.first_name %} {% render_field form.last_name %}
+
+ |
+
+
+ |
+
+ *
+
+ |
+
+
+ {% render_field form.phone_number %}
+
+ |
+
+
+ |
+
+ *
+
+ |
+
+
+ {% render_field form.institute %}
Enter your institute/ organisation/ company
+
+ |
+
+
+ |
+
+ *
+
+ |
+
+
+ {% render_field form.how_did_you_hear_about_us %}
+
+ |
+
+
+
+ |
+
+ * marked fields are mandatory. Please enter the correct information. It will help us to solve your issues in short timespan.
+
+ |
+
+