{"id":3510,"date":"2019-09-10T06:45:16","date_gmt":"2019-09-10T06:45:16","guid":{"rendered":"https:\/\/tmckolkata.com\/tmc\/education\/form-first-frcr-2\/"},"modified":"2025-06-05T06:35:42","modified_gmt":"2025-06-05T06:35:42","slug":"form-prep-frcr2a","status":"publish","type":"page","link":"https:\/\/tmckolkata.com\/in\/education\/form-prep-frcr2a\/","title":{"rendered":"FORM-FRCR 2A PREPARATORY COURSE"},"content":{"rendered":"<div id='av-layout-grid-1'  class='av-layout-grid-container av-3znmz6-f261ea6a19a67a36367cd24bf4acbbb7 entry-content-wrapper main_color av-fixed-cells  avia-builder-el-0  el_before_av_section  avia-builder-el-first   container_wrap sidebar_right'  >\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-3tm3yi-fc7ae0fce647ad136c896095040855a0\">\n.flex_cell.av-3tm3yi-fc7ae0fce647ad136c896095040855a0{\nvertical-align:middle;\nbackground:url(https:\/\/tmckolkata.com\/in\/wp-content\/uploads\/2023\/05\/common_header_2.jpg) 50% 50% no-repeat scroll #c1c1c1;\n}\n.responsive #top #wrap_all .flex_cell.av-3tm3yi-fc7ae0fce647ad136c896095040855a0{\npadding:100px 100px 100px 100px !important;\n}\n<\/style>\n<div class='flex_cell av-3tm3yi-fc7ae0fce647ad136c896095040855a0 av-gridrow-cell av_one_full no_margin  avia-builder-el-1  avia-builder-el-no-sibling  content-align-middle avia-full-stretch'  ><div class='flex_cell_inner'><\/div><\/div>\n<\/div>\n<div id='av_section_1'  class='avia-section av-3l6hei-2668c288c7033cfbd79b01ac6249351d main_color avia-section-default avia-no-border-styling  avia-builder-el-2  el_after_av_layout_row  el_before_av_layout_row  avia-bg-style-scroll container_wrap sidebar_right'  ><div class='container av-section-cont-open' ><div class='template-page content  av-content-small alpha units'><div class='post-entry post-entry-type-page post-entry-3510'><div class='entry-content-wrapper clearfix'>\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-maqadm8s-3e1a598d387862d4bc88d2159c93f39d\">\n.av_promobox.av-maqadm8s-3e1a598d387862d4bc88d2159c93f39d{\ncolor:#ffffff;\nbackground:#444444;\nborder-color:#333333;\n}\n<\/style>\n<div  class='av_promobox av-maqadm8s-3e1a598d387862d4bc88d2159c93f39d avia-button-no  avia-builder-el-3  el_before_av_heading  avia-builder-el-first '><div class='avia-promocontent'><p style=\"text-align: center;\"><strong><span style=\"font-size: 12.0pt;\">FOR KIND ATTENTION OF INTERNATIONAL CANDIDATES<\/span><\/strong><\/p>\n<p style=\"text-align: justify;\">Please note that since the refund of international transactions by DEBIT\/CREDIT CARDS has become near impossible due to rules put in place by the Reserve Bank of India and hence we allow only registration by bank transfer for international candidates. Payments made through bank transfer (NEFT) can still be refunded in case of cancellation.<\/p>\n<p style=\"text-align: justify;\">If facing technical challenges with regard to payment, please reach out to us and we will do the needful to help you.<\/p>\n<p style=\"text-align: center;\"><span style=\"font-size: 12.0pt;\">*This restriction is not applicable to Indian candidates*<\/span><\/p>\n<\/div><\/div>\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-kgal0mcb-25c7541535a3bf519ce31240c5c1a988\">\n#top .av-special-heading.av-kgal0mcb-25c7541535a3bf519ce31240c5c1a988{\npadding-bottom:10px;\n}\nbody .av-special-heading.av-kgal0mcb-25c7541535a3bf519ce31240c5c1a988 .av-special-heading-tag .heading-char{\nfont-size:25px;\n}\n.av-special-heading.av-kgal0mcb-25c7541535a3bf519ce31240c5c1a988 .av-subheading{\nfont-size:15px;\n}\n<\/style>\n<div  class='av-special-heading av-kgal0mcb-25c7541535a3bf519ce31240c5c1a988 av-special-heading-h2 blockquote modern-quote modern-centered  avia-builder-el-4  el_after_av_promobox  el_before_av_one_half '><h2 class='av-special-heading-tag '  itemprop=\"headline\"  >LEEDS \u2013TMC FRCR 2A PREPARATORY COURSE, CLINICAL ONCOLOGY<\/h2><div class=\"special-heading-border\"><div class=\"special-heading-inner-border\"><\/div><\/div><\/div>\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-45el6d-c546d5f4bf1121e0ce2f6cf19405a9c8\">\n.flex_column.av-45el6d-c546d5f4bf1121e0ce2f6cf19405a9c8{\nborder-radius:0px 0px 0px 0px;\npadding:0px 0px 0px 0px;\n}\n<\/style>\n<div  class='flex_column av-45el6d-c546d5f4bf1121e0ce2f6cf19405a9c8 av_one_half  avia-builder-el-5  el_after_av_heading  el_before_av_one_half  first flex_column_div av-zero-column-padding  '     ><p>\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-kgalfibl-1451c52b434e7ce1f55a821e3e03c71a\">\n#top .av-special-heading.av-kgalfibl-1451c52b434e7ce1f55a821e3e03c71a{\npadding-bottom:10px;\n}\nbody .av-special-heading.av-kgalfibl-1451c52b434e7ce1f55a821e3e03c71a .av-special-heading-tag .heading-char{\nfont-size:25px;\n}\n.av-special-heading.av-kgalfibl-1451c52b434e7ce1f55a821e3e03c71a .av-subheading{\nfont-size:15px;\n}\n<\/style>\n<div  class='av-special-heading av-kgalfibl-1451c52b434e7ce1f55a821e3e03c71a av-special-heading-h2 blockquote modern-quote  avia-builder-el-6  el_before_av_contact  avia-builder-el-first '><h2 class='av-special-heading-tag '  itemprop=\"headline\"  >Registration Form<\/h2><div class='av-subheading av-subheading_below'><p>WITH <strong>Direct Transfer<\/strong> , <strong>NEFT <\/strong> OR <strong>UPI <\/strong>PAYMENT OPTION<\/p>\n<\/div><div class=\"special-heading-border\"><div class=\"special-heading-inner-border\"><\/div><\/div><\/div><br \/>\n<form action=\"https:\/\/tmckolkata.com\/in\/education\/form-prep-frcr2a\/\" method=\"post\" data-fields-with-error=\"Found errors in the following field(s):\" class=\"avia_ajax_form av-form-labels-visible   avia-builder-el-7  el_after_av_heading  el_before_av_heading   \" data-avia-form-id=\"1\" data-avia-redirect='' ><fieldset><div id='avia_1_1' class='av-form-text'><p>\n<strong>Personal Information:<\/strong><\/p>\n<\/div><p class='  first_form  form_element form_fullwidth' id='element_avia_2_1'><label for=\"avia_2_1\">Name <abbr class=\"required\" title=\"required\">*<\/abbr><\/label> <input name=\"avia_2_1\" class=\"text_input is_empty\" type=\"text\" id=\"avia_2_1\" value=\"\" \/><\/p><p class='  first_form  form_element form_element_two_third' id='element_avia_3_1'><label for=\"avia_3_1\">E-Mail <abbr class=\"required\" title=\"required\">*<\/abbr><\/label> <input name=\"avia_3_1\" class=\"text_input is_email\" type=\"text\" id=\"avia_3_1\" value=\"\" \/><\/p><p class='  form_element form_element_third' id='element_avia_4_1'><label for=\"avia_4_1\">Contact Number <abbr class=\"required\" title=\"required\">*<\/abbr><\/label> <input name=\"avia_4_1\" class=\"text_input is_empty\" type=\"text\" id=\"avia_4_1\" value=\"\" \/><\/p><p class='  first_form  form_element form_fullwidth' id='element_avia_5_1'><label for=\"avia_5_1\">Address <abbr class=\"required\" title=\"required\">*<\/abbr><\/label> <input name=\"avia_5_1\" class=\"text_input is_empty\" type=\"text\" id=\"avia_5_1\" value=\"\" \/><\/p><p class='  first_form  form_element form_element_half' id='element_avia_6_1'><label for=\"avia_6_1\">City <abbr class=\"required\" title=\"required\">*<\/abbr><\/label> <input name=\"avia_6_1\" class=\"text_input is_empty\" type=\"text\" id=\"avia_6_1\" value=\"\" \/><\/p><p class='  form_element form_element_half' id='element_avia_7_1'><label for=\"avia_7_1\">Country <abbr class=\"required\" title=\"required\">*<\/abbr><\/label> <input name=\"avia_7_1\" class=\"text_input is_empty\" type=\"text\" id=\"avia_7_1\" value=\"\" \/><\/p><p class='  first_form  form_element form_fullwidth' id='element_avia_8_1'><label for=\"avia_8_1\">Current Description of Work <abbr class=\"required\" title=\"required\">*<\/abbr><\/label><select  name=\"avia_8_1\" class=\"select is_empty\" id=\"avia_8_1\"><option   value='Select'>Select<\/option><option   value='Undergoing Specialist Training in Radiation\/Clinical Oncology - (i.e Residency MD\/DNB Training)'>Undergoing Specialist Training in Radiation\/Clinical Oncology - (i.e Residency MD\/DNB Training)<\/option><option   value='Completed Specialist Training in a More Senior Training Position (i.e Fellowship \/ Senior Residency)'>Completed Specialist Training in a More Senior Training Position (i.e Fellowship \/ Senior Residency)<\/option><option   value='In a Consultant \/ Faculty Position'>In a Consultant \/ Faculty Position<\/option><\/select><\/p><p class='  first_form  form_element form_fullwidth' id='element_avia_9_1'><label for=\"avia_9_1\">Place of Work (Name of hospital \/ Institution) <abbr class=\"required\" title=\"required\">*<\/abbr><\/label> <input name=\"avia_9_1\" class=\"text_input is_empty\" type=\"text\" id=\"avia_9_1\" value=\"\" \/><\/p><div id='avia_10_1' class='av-form-text'><p>\n<strong>Academic Information:<\/strong><\/p>\n<\/div><p class='  first_form  form_element form_fullwidth' id='element_avia_11_1'><label for=\"avia_11_1\">Have you appeared for the FRCR Part-1 examination? <abbr class=\"required\" title=\"required\">*<\/abbr><\/label><select  name=\"avia_11_1\" class=\"select is_empty\" id=\"avia_11_1\"><option   value='Yes'>Yes<\/option><option   value='No'>No<\/option><\/select><\/p><p class='  first_form  form_element form_fullwidth' id='element_avia_12_1'><label for=\"avia_12_1\">Have you passed the exam? If yes, Please select the papers that you have passed. \b (Ctrl + Click to select multiple options) <abbr class=\"required\" title=\"required\">*<\/abbr><\/label><select multiple name=\"avia_12_1\" class=\"select is_empty av-multi-select\" id=\"avia_12_1\"><option   value='Radiobiology Cancer biology'>Radiobiology Cancer biology<\/option><option   value='Physics'>Physics<\/option><option   value='Statistics'>Statistics<\/option><option   value='Pharmacology'>Pharmacology<\/option><\/select><\/p><p class='  first_form  form_element form_fullwidth' id='element_avia_13_1'><label for=\"avia_13_1\">Have you appeared for FRCR 2A Exam? <abbr class=\"required\" title=\"required\">*<\/abbr><\/label><select  name=\"avia_13_1\" class=\"select is_empty\" id=\"avia_13_1\"><option   value='Yes'>Yes<\/option><option   value='No'>No<\/option><\/select><\/p><p class='  first_form  form_element form_fullwidth' id='element_avia_14_1'><label for=\"avia_14_1\">Have you passed FRCR 2A? <abbr class=\"required\" title=\"required\">*<\/abbr><\/label><select  name=\"avia_14_1\" class=\"select is_empty\" id=\"avia_14_1\"><option   value='Yes'>Yes<\/option><option   value='No'>No<\/option><\/select><\/p><div id='avia_15_1' class='av-form-text'><p>\n<strong>Payment:<\/strong><\/p>\n<\/div><p class='  first_form  form_element form_fullwidth' id='element_avia_16_1'><label for=\"avia_16_1\">Payment Mode <abbr class=\"required\" title=\"required\">*<\/abbr><\/label><select  name=\"avia_16_1\" class=\"select is_empty\" id=\"avia_16_1\"><option   value='NEFT \/ Direct Transfer'>NEFT \/ Direct Transfer<\/option><\/select><\/p><p class='  first_form  form_element form_fullwidth' id='element_avia_17_1'><label for=\"avia_17_1\">NEFT \/ Transfer Reference No <abbr class=\"required\" title=\"required\">*<\/abbr><\/label> <input name=\"avia_17_1\" class=\"text_input is_empty\" type=\"text\" id=\"avia_17_1\" value=\"\" \/><\/p><p class='  first_form  form_element form_fullwidth' id='element_avia_18_1'><label for=\"avia_18_1\">NEFT \/ Transfer Date <abbr class=\"required\" title=\"required\">*<\/abbr><\/label> <input name=\"avia_18_1\" class=\"text_input is_empty\" type=\"text\" id=\"avia_18_1\" value=\"\" \/><\/p><p class='  first_form  form_element form_fullwidth' id='element_avia_19_1'><label for=\"avia_19_1\">NEFT \/ Transfer Amount <abbr class=\"required\" title=\"required\">*<\/abbr><\/label><select  name=\"avia_19_1\" class=\"select is_empty\" id=\"avia_19_1\"><option   value='40000 (INR)'>40000 (INR)<\/option><\/select><\/p><p class=\"hidden\"><input type=\"text\" name=\"avia_20_1\" class=\"hidden \" id=\"avia_20_1\" value=\"\" \/><\/p><div id='avia_21_1' class='av-recaptcha-area  first_form  form_element form_fullwidth '  data-container_class=\"\" data-custom_class=\"\" data-context=\"av_contact_form\" data-token_input=\"av_recaptcha_token\" data-version=\"avia_recaptcha_v3\" data-theme=\"light\" data-size=\"normal\" data-score=\"0.5\" data-text_to_preview=\"\" data-value=\"\"><div class=\"av-google-badge-message hidden\">This site is protected by reCAPTCHA and the Google <a href=\"https:\/\/policies.google.com\/privacy\" target=\"_blank\" rel=\"noopener noreferrer\">Privacy Policy<\/a> and <a href=\"https:\/\/policies.google.com\/terms\" target=\"_blank\" rel=\"noopener noreferrer\">Terms of Service<\/a> apply.<\/div><\/div><p class=\"form_element \"><input type=\"hidden\" value=\"1\" name=\"avia_generated_form1\" \/><input type=\"submit\" value=\"Submit\" class=\"button\"  data-sending-label=\"Sending\"\/><\/p><\/fieldset><div class=\"avia-disabled-form\">This contact form is deactivated because you refused to accept Google reCaptcha service which is necessary to validate any messages sent by the form.<\/div><\/form><div id=\"ajaxresponse_1\" class=\"ajaxresponse ajaxresponse_1 hidden\"><\/div><br \/>\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-l8labva4-22a04bced6a426f6d66903c007fc2665\">\n#top .av-special-heading.av-l8labva4-22a04bced6a426f6d66903c007fc2665{\npadding-bottom:10px;\n}\nbody .av-special-heading.av-l8labva4-22a04bced6a426f6d66903c007fc2665 .av-special-heading-tag .heading-char{\nfont-size:25px;\n}\n.av-special-heading.av-l8labva4-22a04bced6a426f6d66903c007fc2665 .av-subheading{\nfont-size:15px;\n}\n<\/style>\n<div  class='av-special-heading av-l8labva4-22a04bced6a426f6d66903c007fc2665 av-special-heading-h3  avia-builder-el-8  el_after_av_contact  el_before_av_textblock '><h3 class='av-special-heading-tag '  itemprop=\"headline\"  >Bank Detail for NEFT Payment<\/h3><div class=\"special-heading-border\"><div class=\"special-heading-inner-border\"><\/div><\/div><\/div><br \/>\n<section  class='av_textblock_section av-kgall9mv-afacfc06c73076694035ad5790954c54 '   itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock'  itemprop=\"text\" ><p><strong>Account Name:<\/strong>\u00a0Tata Medical Centre Trust<br \/>\n<strong>Bank Name:\u00a0<\/strong>HDFC Bank Limited<br \/>\n<strong>Bank Account Number:<\/strong>\u00a000601-6600-00021<br \/>\n<strong>Bank Account Type:<\/strong>\u00a0Savings Account<br \/>\n<strong>Bank Branch:<\/strong>\u00a0Fort Mumbai<br \/>\n<strong>IFSC :<\/strong>\u00a0HDFC0000060<\/p>\n<\/div><\/section><\/p><\/div>\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-45el6d-29-91cfc1ff83bb69a10a52f4e23f9bd2c4\">\n.flex_column.av-45el6d-29-91cfc1ff83bb69a10a52f4e23f9bd2c4{\nborder-radius:0px 0px 0px 0px;\npadding:0px 0px 0px 0px;\n}\n<\/style>\n<div  class='flex_column av-45el6d-29-91cfc1ff83bb69a10a52f4e23f9bd2c4 av_one_half  avia-builder-el-10  el_after_av_one_half  avia-builder-el-last  flex_column_div av-zero-column-padding  '     ><p>\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-kgalrppc-7aa66022edd69048ba29cdeef627fdd9\">\n#top .av-special-heading.av-kgalrppc-7aa66022edd69048ba29cdeef627fdd9{\npadding-bottom:10px;\n}\nbody .av-special-heading.av-kgalrppc-7aa66022edd69048ba29cdeef627fdd9 .av-special-heading-tag .heading-char{\nfont-size:25px;\n}\n.av-special-heading.av-kgalrppc-7aa66022edd69048ba29cdeef627fdd9 .av-subheading{\nfont-size:15px;\n}\n<\/style>\n<div  class='av-special-heading av-kgalrppc-7aa66022edd69048ba29cdeef627fdd9 av-special-heading-h2 blockquote modern-quote  avia-builder-el-11  el_before_av_contact  avia-builder-el-first '><h2 class='av-special-heading-tag '  itemprop=\"headline\"  >Registration Form<\/h2><div class='av-subheading av-subheading_below'><p>WITH <strong>CREDIT CARD <\/strong> OR <strong>DEBIT CARD <\/strong>PAYMENT OPTION<\/p>\n<\/div><div class=\"special-heading-border\"><div class=\"special-heading-inner-border\"><\/div><\/div><\/div><br \/>\n<form action=\"https:\/\/tmckolkata.com\/in\/education\/form-prep-frcr2a\/\" method=\"post\" data-fields-with-error=\"Found errors in the following field(s):\" class=\"avia_ajax_form av-form-labels-visible   avia-builder-el-12  el_after_av_heading  el_before_av_textblock   \" data-avia-form-id=\"2\" data-avia-redirect='https:\/\/www.tmckolkata.com\/apps\/events\/1113' ><fieldset><div id='avia_1_2' class='av-form-text'><p>\n<strong>Personal Information:<\/strong><\/p>\n<\/div><p class='  first_form  form_element form_fullwidth' id='element_avia_2_2'><label for=\"avia_2_2\">Name <abbr class=\"required\" title=\"required\">*<\/abbr><\/label> <input name=\"avia_2_2\" class=\"text_input is_empty\" type=\"text\" id=\"avia_2_2\" value=\"\" \/><\/p><p class='  first_form  form_element form_element_two_third' id='element_avia_3_2'><label for=\"avia_3_2\">E-Mail <abbr class=\"required\" title=\"required\">*<\/abbr><\/label> <input name=\"avia_3_2\" class=\"text_input is_email\" type=\"text\" id=\"avia_3_2\" value=\"\" \/><\/p><p class='  form_element form_element_third' id='element_avia_4_2'><label for=\"avia_4_2\">Contact Number <abbr class=\"required\" title=\"required\">*<\/abbr><\/label> <input name=\"avia_4_2\" class=\"text_input is_empty\" type=\"text\" id=\"avia_4_2\" value=\"\" \/><\/p><p class='  first_form  form_element form_fullwidth' id='element_avia_5_2'><label for=\"avia_5_2\">Address <abbr class=\"required\" title=\"required\">*<\/abbr><\/label> <input name=\"avia_5_2\" class=\"text_input is_empty\" type=\"text\" id=\"avia_5_2\" value=\"\" \/><\/p><p class='  first_form  form_element form_element_half' id='element_avia_6_2'><label for=\"avia_6_2\">City <abbr class=\"required\" title=\"required\">*<\/abbr><\/label> <input name=\"avia_6_2\" class=\"text_input is_empty\" type=\"text\" id=\"avia_6_2\" value=\"\" \/><\/p><p class='  form_element form_element_half' id='element_avia_7_2'><label for=\"avia_7_2\">Country <abbr class=\"required\" title=\"required\">*<\/abbr><\/label> <input name=\"avia_7_2\" class=\"text_input is_empty\" type=\"text\" id=\"avia_7_2\" value=\"\" \/><\/p><p class='  first_form  form_element form_fullwidth' id='element_avia_8_2'><label for=\"avia_8_2\">Current Description of Work <abbr class=\"required\" title=\"required\">*<\/abbr><\/label><select  name=\"avia_8_2\" class=\"select is_empty\" id=\"avia_8_2\"><option   value='Select'>Select<\/option><option   value='Undergoing Specialist Training in Radiation\/Clinical Oncology - (i.e Residency MD\/DNB Training)'>Undergoing Specialist Training in Radiation\/Clinical Oncology - (i.e Residency MD\/DNB Training)<\/option><option   value='Completed Specialist Training in a More Senior Training Position (i.e Fellowship \/ Senior Residency)'>Completed Specialist Training in a More Senior Training Position (i.e Fellowship \/ Senior Residency)<\/option><option   value='In a Consultant \/ Faculty Position'>In a Consultant \/ Faculty Position<\/option><\/select><\/p><p class='  first_form  form_element form_fullwidth' id='element_avia_9_2'><label for=\"avia_9_2\">Place of Work (Name of hospital \/ Institution) <abbr class=\"required\" title=\"required\">*<\/abbr><\/label> <input name=\"avia_9_2\" class=\"text_input is_empty\" type=\"text\" id=\"avia_9_2\" value=\"\" \/><\/p><div id='avia_10_2' class='av-form-text'><p>\n<strong>Academic Information:<\/strong><\/p>\n<\/div><p class='  first_form  form_element form_fullwidth' id='element_avia_11_2'><label for=\"avia_11_2\">Have you appeared for the FRCR Part-1 examination? <abbr class=\"required\" title=\"required\">*<\/abbr><\/label><select  name=\"avia_11_2\" class=\"select is_empty\" id=\"avia_11_2\"><option   value='Yes'>Yes<\/option><option   value='No'>No<\/option><\/select><\/p><p class='  first_form  form_element form_fullwidth' id='element_avia_12_2'><label for=\"avia_12_2\">Have you passed the exam? If yes, Please select the papers that you have passed. \b (Ctrl + Click to select multiple options) <abbr class=\"required\" title=\"required\">*<\/abbr><\/label><select multiple name=\"avia_12_2\" class=\"select is_empty av-multi-select\" id=\"avia_12_2\"><option   value='Radiobiology Cancer biology'>Radiobiology Cancer biology<\/option><option   value='Physics'>Physics<\/option><option   value='Statistics'>Statistics<\/option><option   value='Pharmacology'>Pharmacology<\/option><\/select><\/p><p class='  first_form  form_element form_fullwidth' id='element_avia_13_2'><label for=\"avia_13_2\">Have you appeared for FRCR 2A Exam? <abbr class=\"required\" title=\"required\">*<\/abbr><\/label><select  name=\"avia_13_2\" class=\"select is_empty\" id=\"avia_13_2\"><option   value='Yes'>Yes<\/option><option   value='No'>No<\/option><\/select><\/p><p class='  first_form  form_element form_fullwidth' id='element_avia_14_2'><label for=\"avia_14_2\">Have you passed FRCR 2A? <abbr class=\"required\" title=\"required\">*<\/abbr><\/label><select  name=\"avia_14_2\" class=\"select is_empty\" id=\"avia_14_2\"><option   value='Yes'>Yes<\/option><option   value='No'>No<\/option><\/select><\/p><div id='avia_15_2' class='av-form-text'><p>\n<strong>Payment:<\/strong><\/p>\n<\/div><p class='  first_form  form_element form_fullwidth' id='element_avia_16_2'><label for=\"avia_16_2\">Payment Mode <abbr class=\"required\" title=\"required\">*<\/abbr><\/label><select  name=\"avia_16_2\" class=\"select is_empty\" id=\"avia_16_2\"><option   value='Credit Card'>Credit Card<\/option><option   value='Debit Card'>Debit Card<\/option><\/select><\/p><p class=\"hidden\"><input type=\"text\" name=\"avia_17_2\" class=\"hidden \" id=\"avia_17_2\" value=\"\" \/><\/p><div id='avia_18_2' class='av-recaptcha-area  first_form  form_element form_fullwidth '  data-container_class=\"\" data-custom_class=\"\" data-context=\"av_contact_form\" data-token_input=\"av_recaptcha_token\" 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