Students planNursing students registration₹105.00Select Your Payment CycleMembership FeesStudents*First Name * First NameFirst Name can not be left blank.Please enter valid data.This first name is invalid. Please enter a valid first name.*Last Name * Last NameLast Name can not be left blank.Please enter valid data.This last name is invalid. Please enter a valid last name.*Mobile No * Mobile No Text field can not be left blank.Please enter valid data.Please enter valid data.With country code*Address * AddressThis Field can not be left blank.Please enter valid data.*Date of birth * Date of birthPlease select date.Invalid Date.GenderMaleFemalePlease select one.Please enter valid data.*PIN Code * PIN CodeText field can not be left blank.Please enter valid data.Please enter valid data.*Institute Name * Institute NameText field can not be left blank.Please enter valid data.*CourseGNMBSCMSCPlease select one option.Please enter valid data.Country/RegionCountry/RegionCountry/RegionAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongoCosta RicaCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFijiFinlandFranceFrench GuianaFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorwayNorthern Mariana IslandsOmanPakistanPalauPalestinePanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarReunion IslandRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbia and MontenegroSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwePlease select atleast one option.Please enter valid data.*Upload photo * Upload photoDrop file here or click to select.Please select file.Invalid file selected.Invalid file selected.Max 2MB File sizeRemarks RemarksThis Field can not be left blank.Please enter valid data.Account signup *Username * UsernameUsername can not be left blank.Please enter valid data.This username is already registered, please choose another one.This username is invalid. Please enter a valid username.*Email Address * Email AddressEmail Address can not be left blank.Please enter valid email address.Please enter valid email address.This email is already registered, please choose another one.*Password * PasswordPassword can not be left blank.Please enter valid data.Please enter at least 6 characters.Strength: Very Weakby checking this box you agree below terms and conditionsPlease check atleast one option.Please enter valid data.1. I Accept United Nurses Association by-law, br> 2.I'm having a clean profile No disciplinary action has been taken by the UNA State Committee so far 3 I hereby declare that the information provided is true and correct. I also understand that any willful dishonesty may render for refusal of this application and paid amount not refunded.cropSkip(Use Cropper to set image and use mouse scroller for zoom image.) Select Your Payment GatewayOnline PaymentHow you want to pay? Auto Debit Payment Manual PaymentPayment SummaryYour currently selected plan : , Plan Amount : Coupon Discount Amount : , Final Payable Amount: Submit