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igenius College Planner

Personal Details

Child's Details

First Name*

Please enter child's first name.

Last Name*

Please enter child's last name.

Gender*

Please select child's gender.

Date of Birth*

Please select child's date of birth.

Child's School Details

Class as on April 2011

Class as on Jan 1, 2011 or thereafter as per the school session for 2010-2011.

School Name

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Monthly School Fee

Choose the monthly school fee of your child. Please select the Monthly school fee of the child

Parent's Details

Name*

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Date Of Birth*

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Email Id*

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ex: test@test.com

Mobile Phone No.*

Please put your mobile phone number starting with '8' or '9'

Telephone No.(Landline)*

- STD Code - Phone No(011-44556688)

Address Details

House No./ Building Name*

Character limit is 200 for house no./street

Street

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Locality*

Character limit is 200 for locality

State *

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City*

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Pin Code*

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Login Details

User Name*

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Password*

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Confirm Password*

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The information submitted by me including names, address, mobile/phone numbers, e-mail identity and/or any other information provided by me on this website may be used by MNYL for promotional purpose including sending out commercial information, via different modes of communication and/or for other publicity purposes and/or for solicitation of insurance business to me or the persons, whose information was provided by me.

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LIFE INSURANCE COVERAGE IS AVAILABLE IN THIS PRODUCT.
Max New York Life Insurance Company Limited is a joint venture of Max India Limited and New York Life International LLC. Address: 11th floor, DLF Square Building, Jacaranda Marg, DLF City Phase II, Gurgaon (Haryana) 122002. Contact toll-free numbers 1800 180 5577 (for MTNL & BSNL lines) or 1800 200 5577 (from other service providers) Insurance is the subject matter of solicitation. For more details on risk factors, Terms and conditions , please read sales brochure carefully before concluding a sale. Guaranteed and non guaranteed benefits are applicable only if all the due premiums are paid. UIN 104N065V01 ARN: MNYL/Ads/Euro/College Plan/13

Visit us at www.maxnewyorklife.com