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CosmoClub Registration Form 2024

Cosmofluencer > CosmoClub Registration Form 2024

Personal Details

Name *

Phone *Please enter the number in the format specified0 / 10

Email Address *

Instagram Handle

What are you currently doing? *WorkingStudying

Choose Your Program Tier

Program Tier Details

Which Subscription Do You Want? *CosmoClub BasicCosmoClub Premium

Education

School / College *

Course *

Class / Grade as of Today *

Town (where the school / college is) *

Work

Current EmployerEnter the name of your company

Designation

A Bit More

Why do you want to join this Club? *

What is your career goal – where do you see yourself in 10 years? *

Payment

Please pay either by scanning the QR Code below or directly via the UPI ID mentioned. After payment, enter the Transaction ID for validation.

Transaction ID *Enter the 12 digit transaction ID for the payment made

Consent *

I permit Giant Leaps Foundation to reach out to me regarding the application to the program, through the details shared above.

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Reach us at: hello@cosmofluencer.com

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