
| 1. | Name | |||||
| 2. | Address | |||||
| 3. | KMC Ward No | |||||
| 4. | Sex | |||||
| 5. | Phone No | Landline | Mobile | |||
| 6. | Cultural Activity you are associated with | |||||
| If you want to write more about your activities please use the space below | ||||||
| 7. | Chose Zonal Committee | |||||
| This is not a membership form but only an expression of interest on your part. Once we have your information we will contact you. | ||||||
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