Your Name (required) [text* your-name]

Date of Birth [number* number-500 min:1 max:31 placeholder "dd"]

/ [number* number-501 min:1 max:12 placeholder "mm"]

/ [number* number-502 min:1930 max:1998 placeholder "yy"]

Mobile No. [tel* tel-981 /10]

Telephone No. [tel* tel-982 /10]

Email id of the Participant (required) [email* your-email]

Address [textarea* textarea-952]

Language of Exam [radio radio-969 "English" "Hindi" "Marathi"]

Select City [select* menu-961 "Select City" "Mumbai" "Outside Mumbai"]