My Care Panchayat - Registration Form
Please register yourself for upcoming My Care Panchayat. My Care Panchayat is the platform to discuss the business opportunities in My Care.
Please write your full name.
My Phone Number
Please write your 10 digit mobile number (Don't add 0 or +91 as prefix)
Please mention your residential address
I wish to participate in upcoming Panchayat
Please mention the date of panchayat you wish to participate. (Example: 1st January 2016)
My Expectations from My Care Panchayat
Please tell us about your expectations from this upcoming Panchayat.
How I was informed about this Panchayat
Please let us know how you came to know about this panchayat.
Phone Call from My Care Office
I am Invited by - Name
Please mention the name of person who has invited you to this panchayat
I am Invited by - Phone Number
Please mention the Phone number of the person who has invited you to this panchayat
A copy of your responses will be emailed to the address you provided.
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