Checkout example · Bootstrap v5.1

iCharge - Get your Prime Membership

Checkout form

Get your Prime Membership with this registration form and get special extra reserved charging ports at each and every charging station in the world. For people who value their Time, Stay away from long queues!

Your cart 2

Prime Membership(4-Wheeler)
Get extra charging ports at each station
Rs.4999
Prime Membership(2-Wheeler)
Get extra charging ports at each station
Rs.2999
Promo code
iCHARGE200
−Rs. 200
Total (Rs.) Rs.7798

Application Form

First name

Valid first name is required.

Last name

Valid last name is required.

Username

Your username is required.

Email (Required)

Please enter a valid email address for shipping updates.

Address

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Address 2 (Optional)

Country

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State

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Pin Code:

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Payment

Credit card

Debit card

UPI

Name on card Full name as displayed on card

Name on card is required

Credit card number

Credit card number is required

Expiration

Expiration date required

CVV

Security code required

iCharge - Get your Prime Membership

Checkout form

Your cart 2

Prime Membership(4-Wheeler)

Prime Membership(2-Wheeler)

Promo code

Application Form

Payment