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Dont Give fake address because your ip address is going to be tracked
  First Name *   Last Name *
  User Name  * (College Register NO. must be your Username . )
  Password *   Confirm Password *
  Date Of Birth (dd/mm/yyyy)   Gender *
  Batch  (year of passing) *   Branch *
  Address *    
  City    
  State/Province   Zip/Postal Code
  Phone/Mobile *   Email *

Work place information
  Organization   Designation
  Address   Work Domain
  Country
  City    
  State/Province   Zip/Postal Code
  Work Phone   FAX
  Email   URL

  Note:(*) = Mandatory