diff --git a/src/routes/form/+page.svelte b/src/routes/form/+page.svelte
index 437c6d6..79f23c5 100644
--- a/src/routes/form/+page.svelte
+++ b/src/routes/form/+page.svelte
@@ -1,10 +1,11 @@
-<p>
-	Fill in your payment details
-</p>
+<p>Fill in your payment details</p>
 
 <form class="grid grid-cols-[2fr_3fr] w-4/5 md:w-2/3 gap-2 md:gap-4 mx-auto">
+	<label for="name">Name of the student</label>
+	<input type="text" id="name" name="name" />
+
 	<label for="programme">Pick your programme</label>
-	<select id="programme">
+	<select id="programme" name="programme">
 		<option value="ug">UG Undergraduate</option>
 		<option value="pg">PG Postgraduate</option>
 		<option value="phd">PhD Doctorate</option>
@@ -23,4 +24,72 @@
 		<option value="9">Sem IX</option>
 		<option value="10">Sem X</option>
 	</select>
+
+	<label for="roll">Roll No</label>
+	<input type="text" id="roll" name="roll" />
+
+	<label for="category">Category</label>
+	<select id="category">
+		<option value="gen">General</option>
+		<option value="ews">EWS</option>
+		<option value="obc">OBC</option>
+		<option value="wdp">WDP</option>
+		<option value="sc">SC</option>
+		<option value="st">ST</option>
+		<option value="vhc">VHC</option>
+		<option value="phc">PHC</option>
+	</select>
+
+	<label for="phone">Phone No</label>
+	<input type="tel" id="phone" name="phone" />
+
+	<strong class="col-span-2">Details of the fees payment</strong>
+
+	<label for="acc-holder">Name of the account holder</label>
+	<input type="text" id="acc-holder" name="acc-holder" />
+
+	<label for="acc-no">Account No</label>
+	<input type="text" inputmode="numeric" id="acc-no" name="acc-no" />
+
+	<label for="bank">Name of the bank</label>
+	<input type="text" id="bank" name="bank" />
+
+	<label for="branch">Branch</label>
+	<input type="text" id="branch" name="branch" />
+
+	<label for="ifsc">IFSC code</label>
+	<input type="text" id="ifsc" name="ifsc" />
+
+	<label for="paid-amt">Amount paid</label>
+	<input type="text" inputmode="numeric" id="paid-amt" name="paid-amt" />
+
+	<label for="pay-date">Date of Payment</label>
+	<input type="date" id="pay-date" name="bank" />
+
+	<label for="mode">Payment Mode</label>
+	<select id="mode" name="mode">
+		<option value="neft">NEFT</option>
+		<option value="sbi">SBI to SBI</option>
+		<option value="deb">Debit card</option>
+		<option value="cre">Credit card</option>
+	</select>
+
+	<label for="transaction-no">Transaction Number</label>
+	<input type="text" id="transaction-no" name="transaction-no" />
+
+	<label for="reference-no">Reference Number</label>
+	<input type="text" id="reference-no" name="reference-no" />
+
+	<label for="utr">UTR Number</label>
+	<input type="text" id="utr" name="utr" />
+
+	<label for="inb">INB Reference Number (for transfer from SBI to SBI)</label>
+	<input type="text" id="inb" name="inb" />
+
+	<strong class="col-span-2">Details of the fees payment</strong>
+
+	<ol>
+		<li>A scanned copy of the receipt/counterfoil</li>
+		<li>Screenshot of the message regarding payment of fees</li>
+	</ol>
 </form>