Member Details
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First Name *
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*
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Last Name *
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*
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Type *
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Select
Member
Newly Inducted Member
Guest
*
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Mobile Number *
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*
*
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Primary Email_ID/ *
Username
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*
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Alternate Email_ID
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*
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Password
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*
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Date of Birth *
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Date
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Month
January
Feburary
March
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June
July
August
September
October
November
December
(DD - MM)
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Anniversary Date
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Date
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Month
January
Feburary
March
April
May
June
July
August
September
October
November
December
(DD - MM)
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Address
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*
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State
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Select State
Andhra Pradesh
Arunachal Pradesh
Assam
Bihar
Chhattisgarh
Goa
Gujarat
Haryana
Himachal Pradesh
Jammu & Kashmir
Jharkhand
Karnataka
Kerla
Madhya Pradesh
Maharashtra
Manipur
Meghalaya
Mizoram
Nagaland
Orissa
Punjab
Sikkim
Tamilnadu
Tripura
Uttar Pradesh
Uttaranchal
West Bengal
Outside India
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Pincode
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*
*
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City
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*
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Upload Photo
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*
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Spouse Details
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Image
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Name
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Mobile Number
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*
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Email_ID
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*
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Date of Birth
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Date
1
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26
27
28
29
30
31
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Month
January
Feburary
March
April
May
June
July
August
September
October
November
December
(DD - MM)
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Upload Photo
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*
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Child Details
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1. Child Name
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Child BirthDate
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Date
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Month
January
Feburary
March
April
May
June
July
August
September
October
November
December
(DD - MM)
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2. Child Name
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Child BirthDate
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Date
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12
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27
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29
30
31
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Month
January
Feburary
March
April
May
June
July
August
September
October
November
December
(DD - MM)
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