Sure! Here’s a suggested form format for a Student Program Application on your eCommerce website. This form can help you gather key information for verifying students and offering them special discounts or access.

🎓 Student Program Application Form

1. Personal Information

• Full Name (text)
• Email Address (email)
• Phone Number (optional) (tel)

2. Academic Details

• School/University Name (text)
• Student ID Number (text)
• Field of Study (text or dropdown)
• Expected Graduation Year (dropdown: YYYY)

3. Verification

• Upload Student ID or Enrollment Proof (file upload – image or PDF)
• Institutional Email (if different from above) (optional, email)

4. Account Information

• Create a Password (password)
• Confirm Password (password)
• Checkbox: ☐ I already have an account on this site

5. Consent

• Checkbox: ☐ I confirm that the information provided is accurate.
• Checkbox: ☐ I agree to receive student program updates and offers via email.
• Checkbox: ☐ I accept the [Terms & Conditions] and [Privacy Policy].

6. Submit

• [Apply Now] (submit button)

Would you like this embedded into a web page or converted into HTML code as well?