AI Consultant Registration

Personal Details

Full Name *

Age *

City *

Pincode *

WhatsApp Number *

Email Address *

Professional Photo * (JPG or PNG, clear face photo)

Professional Background

Last Designation *

Last Organisation *

Total Years of Experience *

Primary Industry / Domain *

Brief Career Summary * (3–4 lines — what you did, what you achieved)

Consulting Domain Preferences

Select Your 3 Preferred Consulting Domains * (in order of preference)

1st

2nd

3rd

AI Capabilities

AI4Seniors Level Completed *

One AI Application You Have Done Successfully *

Availability & Fees

Preferred Engagement *

Availability *

Expected Fee per Visit *

Cities Willing to Travel To (optional)

Any Additional Skills or Services You Can Offer (optional)

Any Other Information You Would Like to Share (optional)

Note on Financial Terms: Commission structure, AI4Seniors mentoring fee for first 3 assignments, and social contribution model (10% to senior welfare fund) are as per the separate annexure shared by Mentor Umesh Prabhu at the time of onboarding confirmation. Registration on this form does not constitute a financial commitment.

Important: Your consulting fee per visit (as selected above) will be requested from and paid by your client directly to you. AI4Seniors.in does not collect or deduct consulting fees from your earnings.

Declaration & Agreement

I confirm that all information provided above is true and accurate to the best of my knowledge.

I authorise AI4Seniors.in to display my profile (excluding financial details and photo at my option) on the Situations Wanted directory for a period of 6 months from registration date, or until I receive my first assignment — whichever comes earlier.

I agree to involve Mentor Umesh Prabhu in my first 3 consulting assignments for quality assurance and mentoring support.

I understand that financial and commission terms are as per the separate annexure provided by AI4Seniors.in and I agree to abide by those terms after onboarding.

I commit to representing the AI4Seniors brand with professionalism, integrity, and respect for all clients. I understand that AI4Seniors.in acts only as a directory and mentoring platform and is not responsible for consulting outcomes.

AI4Seniors UPI QR code for ₹2,500 payment

Scan to pay Registration Fee — ₹2,500
UPI ID: 9323299059@okbizaxis | Name: Umesh Prabhu
Send payment screenshot to WhatsApp: +91 73044 29059
Registration is confirmed only after payment receipt.

📌 Our Commitment to You — Please Read:

✅ Your profile will be displayed on ai4seniors.in for 6 months from the date of registration.
💰 If AI4Seniors is unable to find you a consulting assignment within 3 months, your registration fee of ₹2,500 will be fully refunded — no questions asked.
⏱️ You may choose to continue your profile display for up to 6 months or until your first assignment is received — whichever comes earlier.
🔄 After 6 months, you may re-register with an updated and improved resume at the prevailing registration fee.

🎉 Thank You for Registering!

Your details have been received. Mentor Umesh Prabhu will personally review your profile and contact you on WhatsApp within 3 working days.

Please ensure you have sent your registration fee payment screenshot to +91 73044 29059.

Your profile will be displayed for 6 months. If no assignment is found within 3 months, your ₹2,500 registration fee will be fully refunded.

Welcome to the AI4Seniors Consultant Mission! 🙏