registration form

Online Course for Insurance Brokers

Welcome to our Online Course for Insurance Brokers! We appreciate you taking the time to provide us with the information we need. Please read the following instructions carefully before filling out the form:

  • Required fields are marked with an asterisk (*). Please make sure to fill them out completely.
  • Once you verify your email address, you will be redirected to a detailed registration form to fill in more details.
  • Once you have completed the form, you will be redirected to make the payments for the selected module.
  • If your payments are successful, you will be enrolled in the system for the selected module and you will be notified with your credentials through email.
  • Please make sure to check your spam or junk folder in case it goes there.
  • Please note that all information you provide will be kept confidential and used only for the purposes stated in the form.

Thank you for your cooperation!

Fresher Registration

Resend OTP

Sponsorship Details *
Educational Qualification: (Select Highest Educational Qualification from the list provided below) *
Please select Qualification for eligibility of 25 hours training *

  Note :  Certificate will be generated based on Required Hours.
Payment Amount : Rs.1416.00/- ( Fresh Course Registration : Rs. 1200/- + 18% GST)
Upload Photograph *

Please Note: Your photograph should be in jpeg format, file size has to be below 30 kb, file name of the photograph that you upload should be given as your PAN Number_Name (e.g. AJCPK1122R_PriyankaDeshmukh.jpeg)

Please Note:
(i). Course Duration: The duration of the course that you select will be for 60 days from the time you make the payments.
(ii). For any support, have a look at Contact Us page
(iii). Please verify the entered PAN Number, E-mail Id, and the Aadhaar Card Number before submitting your registration form.

  I am aware of the Qualification and Eligibility Criteria for Brokers Online Training as prescribed by IRDAI and declare that I have fulfilled the same. I further declare that the information given by me is true and I am aware that if any deviation from facts is noted or noticed, my application will be considered null and void