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BrightBrainsTM Registrations - Individuals

Your Registered Email Id will be your default USER NAME for LOGIN. Once you complete the form, an email confirming successful registration with the User Name/Password will arrive at your Registered Mail-Id. You may then LOGIN into our site and use our services.


Individual User Registration

First Name
Middle Name
Last Name
Birthdate *
Gender *
Registered Email-Id
Re-type Email-Id
Password
Re-type Password
Qualification *
Address Line 1
Address Line 2
City
Country
State
Pincode/Zipcode
Landline
Mobile *



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