Student Registration - EduPhysics Academy

Student Registration Form

Fill in your details and upload payment receipt to complete registration

👤 Personal Information

First Name *

👤

Last Name *

👤

Email Address *

📧

Mobile Number *

📱

Gender *

👨 Male 👩 Female

Address *

📍

📚 Class Information

Select Classes *

Select one or more classes (Rs. 1,000 per class)

🔬 Physics Rs. 1,000 ⚗️ Chemistry Rs. 1,000 📐 Combined Maths Rs. 1,000

💳 Payment Information

🏦

Bank Name: Bank of Ceylon

Branch: Colombo 07

Account Name: EduPhysics Academy

Account Number: 1234567890

ℹ️

Transfer the registration fee based on selected classes and upload the receipt below.

Registration Fee *

💰

Payment Receipt *

Upload a clear photo or scan of your bank transfer receipt (Max 5MB, JPG/PNG/PDF)

📤

Drag & drop your receipt here or browse files

Supported: JPG, PNG, PDF (Max 5MB)

💳 Registration Summary

Selected Classes: None selected

Number of Classes: 0

Total Fee: Rs. 0

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