Enrollment Form for The Ultimate Personal Growth Program

Instructions to Fill the Form

1. Full Name: Enter your complete name as per your official records. Ensure correct spelling.

2. Date of Birth (DOB): Select your date of birth from the calendar dropdown.

3. Gender: Choose your gender from the available options.

4. Email Address: Provide a valid email ID for communication purposes.

5. Contact Number: Enter an active phone number with the country code (if applicable).

6. Student/Employee ID: If you're a student or employee, provide your ID number (if applicable).

7. Address: Fill in your complete address, including street, city, state, and postal code, for receiving exciting gifts.

8. Current Status: Select whether you're a student, employee, freelancer, or other.

9. Field of Study/Work: Mention your academic or professional domain (e.g., Computer Science, Marketing, etc.).

10. Goals: Briefly describe your personal or professional goals.

11. Biggest Challenge: Share any challenges or difficulties you're currently facing in life or career.

12. Fitness Preferences: Indicate your fitness interests (e.g., Yoga, Gym, Outdoor Activities, etc.).

13. Stress Handling: Describe how you currently manage stress (if applicable).

14. Medical Conditions: Mention any health conditions we should be aware of (optional).

15. Preferred Mode of Communication: Select your preferred method for receiving updates (e.g., Email, Phone, SMS).

16. Referral Source: Let us know how you found out about this program (e.g., Social Media, Friend, Website, etc.).

17. Suggestions/Feedback: Provide any ideas or feedback to improve the program (optional).