Read all instructions carefully before filling the form. Ensure that you provide accurate and complete information.Upload Your Photo *Choose FileNo file chosenDelete uploaded filePersonal Information :Full Name / पूरा नाम *Date of Birth / जन्म मिति *Address / ठेगाना *Country *AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBruneiBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChina, People's Republic ofChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrance, MetropolitanFrench GuianaFrench PolynesiaFrench South TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island And Mcdonald IslandHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJohnston IslandJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarReunion IslandRomaniaRussiaRwandaSaint HelenaSaint Kitts and NevisSaint LuciaSaint Pierre & MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and South SandwichSpainSri LankaStateless PersonsSudanSudan, SouthSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwan, Republic of ChinaTajikistanTanzaniaThailandTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks And Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States of America (USA)UruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis And Futuna IslandsWestern SaharaYemenZambiaZimbabwePhone Number / फोन नम्बर *Email / इमेलCitizenship No. / नागरिकता नम्बरGender/लिङ्ग *MaleFemaleOthersStatus/स्थितिSingleMarriedOccupation / पेशाMembership Type :Choose Membership TypeGeneral / सामान्य सदस्यHonorary Member / मानार्थ सदस्यLifetime / आजीवन सदस्यVolunteer / स्वयंसेवकYouth / Student Member (युवा / विद्यार्थी सदस्य)Donor Member (दाता सदस्य)Areas of Interest :Interest AreasEducation / शिक्षाHealth / स्वास्थ्यEnvironment / वातावरणWomen Empowerment / महिला सशक्तिकरणSocial Service / सामाजिक सेवाChild Rights / बालअधिकारConsent *"I hereby declare that the above information is true and I agree to abide by the rules and regulations of the foundation." (म यहाँ दिएको विवरण सत्य हो भनी घोषणा गर्दछु र संस्थाका नियम अनुसार चल्ने प्रतिवद्धता गर्दछु।)Upload Your Signature *Choose FileNo file chosenDelete uploaded fileDate (मिति)For Office Use Only / कार्यालय प्रयोजनका लागि मात्रMembership ID / सदस्यता नम्बर :Date Received / प्राप्त मिति :Approval Status / स्वीकृति स्थिति :Approved / स्वीकृतRejected / अस्वीकृतPending / बाँकीApproved By :President Signature : ..............................................SUBMITPlease do not fill in this field.
