Online Application Forms

Information About Center Head

Name Of Center Head:*

Designation of Center Head:*

Address Of Center Head: *

Contact No. Of Center Head: *

+91

Email Id Of Center Head: *

Date of Birth:*

Nationality:*

Gender:*

Male Female Others

Religion:*

Educational Qualification: *

DECLARATION

I hereby certify that the context started above is correct and true to my knowledge and belief and hereby confirm that our Organization/Society / Trust are free of any legal / official disputes whatsoever. I accept that any facts started above. If found incorrect will automatically result in cancellation for nominations associate. However, I will have no right whatsoever to fight/challenge legally against the judgement in any court of law. All disputes are subject to Kolkata Jurisdiction only. Affiliation/Membership fees once paid will not be refunded in any circumstances.