Individuals Registration

Individuals Registration Form

Dear Members,

a. Please fill all the details as per below, so that it will help us in future to serve our community needs.

b. Below information are not shows in our VBN website. It is only for registration and record purpose.

c. For any Suggestions/Feedback please write to: [email protected]

General Info:
Passport Size Photo
How Do you Know about VBN *
Member Reference ID
Sub-Division *
Username *
Password *
Confirm Password *
Weak Password
Email *
Mr/Mrs *
First Name *
Last Name *
As per Community Certificate *
Select Document 1 *
Upload Proof *
Select Document 2
Upload Proof
Select Category *
Personal Info:
Applicant Name *
Gender *
Marital Status
Father Name/Spouse Name *
Date of Birth *
YYYY
MM
DD
Birth Time
Place of Birth
Profession
Annual Income *
Qualification *
Mother Tongue *
Rasi
Star
Height
Dosham
No. of Brother
No. of Sister
Country Living
Blood Group *
Aadhar Card No *
Voter Id No
Pan Number
Contact Number
Whatsapp No
Physically Challenged
unwanted
unwanted
Address
Company Address
Street Address
Address Line 2
City
State / Province / Region

Zip / Postal Code
Country
Office Address *
Street Address
Address Line 2
City
State / Province / Region

Zip / Postal Code
Country
Residential Address
Street Address
Address Line 2
City
State / Province / Region

Zip / Postal Code
Country
Personal Info:
Your Generation God
Your Generation God Temple Location
Gothram (If you know)
Family Surname /Title (Pattam) / House Name *
Living in Own House
Are you interested to join community developmental activities *
Area of interest in community development activities:
Are you interesed to receive notification of VBN News Email / Whatsapp / Others
Can you refer VBNConnect to other members
Yes
No
Family Members
Name
Gender
DOB
Martial Status
Blood Group
Name
Gender
DOB
Martial Status
Blood Group
Name
Gender
DOB
Martial Status
Blood Group
Name
Gender
DOB
Martial Status
Blood Group
Name
Gender
DOB
Martial Status
Blood Group
Contact Info:
Prefered time to Contact
Landline Number *
Mobile Number
Whatsapp No1
Whatsapp No 2
Prime Email Id
Alternate Email ID *
Telegram ID
Facebook ID
Self Declaration *
By Submitting this form, I hereby certify that I have read the Terms and Conditions and that the information provided on this application is true and accurate to the best of my knowledge.

Individuals Registration

Individuals Registration Form

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