TERAPANTH KISHORE MANDAL MEMBER REGISTRATION FORM

TERAPANTH KISHORE MANDAL

MEMBERSHIP FORM UNDER TKM AXIS
Name*

First NamePlease Enter your gotra, example Dugar, Mandot etc
Phone Number*
Please enter a valid phone number without +91 and 0. Only enter the 10 digit mobile number
WhatsApp Number if different
Please enter a valid WhatsApp number.
Native Place*
Example Deogarh, Pali, Mewar
Date of Birth*

DayMonthYear
Please ensure you fall under the age bracket of 15-21
Email*
example@example.com
Blood Group*
Academic Qualification*
If you are into any business, please mention the field of business you are in.
Father's Name*

First NameLast Name
Mother's Name*

First NameLast Name
Permanent Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Kishore Mandal you belong to*
If you do not know which mandal you are a part of please select the city you reside in.
Are you pursuing your studies from a different city!?*

YesNo
Present Residing / Current Address

Street Address

Street Address 2

CityState / Province

Postal / Zip Code
If you belong to any mandal, where you currently reside
Upload a picture of yourself!*

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Signature*

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Membership ID
Should be Empty:

TERAPANTH KISHORE MANDAL