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GENEXT Enrollment Form - 2023
Sikaria, Dehri On Sone , Rohtas, Bihar.
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* Indicates required question
Name /
नाम
*
Your answer
Date of Birth / जन्म की तारीख
*
MM
/
DD
/
YYYY
Age / आयु
*
Your answer
Gender / लिंग
*
पुरुष
महिला
Marital status / वैवाहिक स्थिति
*
विवाहित
अविवाहित
Educational Qualification / शैक्षणिक योग्यता
*
Your answer
Address / पता
*
Your answer
Mobile No / मोबाइल नंबर
*
Your answer
Email /
मेल पता
*
Your answer
Baptism Date / बपतिस्मा की तारीख
*
MM
/
DD
/
YYYY
No. of years attending the Church / चर्च में भाग लेने वाले वर्षों की संख्या
*
Your answer
Pastor Name / पादरी का नाम
*
Your answer
Name of the church /
चर्च का नाम
*
Your answer
Remarks /
टिप्पणियां
Your answer
I declare that the above information are correct and given out of my conviction.
मैं घोषणा करता हूं कि उपरोक्त जानकारी सही है और मेरे विश्वास से दी गई है।
*
Yes / हाँ
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