Customer Signup - Step 1 (Registration)
	Personnel Details
First Name :
Last Name :
Gender :	Male  Female
Mobile No :
Alternate Mobile No :
Email :
State :	Select Andhra Pradesh Karnataka Kerala Tamil Nadu
City :	Select BANGALORE BELAGAVI DHARWAD HASSAN HUBBLLI MYSURU
Address :
	Bank Details
Account Type :	Select SAVING CURRENT OTHER
Bank :
Branch :
Account No :
IFSC Code :
	Membership Details
Payment Frequency :	Select Payment Frequency Weekly
Franchise :	Select Hitech Work Infotech Solution DDS DHARWAD DDS HUBBLLI DDS DHARWAD1
Source :	Select FRIENDS INTERNET JUST DAIL NEWS PAPER OTHERS PAMPHLETS REFERRAL
Referal ID :
Membership Plan :	Select NORMAL PLAN BASE PLAN EXECUTIVE PLAN SILVER PLAN PLATINUM PLAN GOLD PLAN DIAMOND PLAN ROYAL PLAN
Membership Amount :
Membership Validity :
Rate/Captcha :
Captcha :
Validate Captcha :