Ceylon Scooter Club Membership Form
Note: Below personal details will be used for CSC internal purpose only and will not be shared with any third party.
Full Name *
Facebook Name
Birth Day *
MM
/
DD
/
YYYY
Age *
National Identity Card number (NIC) *
Gender *
Required
Marital Status
Occupation/Profession
Company/Business/Service Name
Email Address
Home Address *
Contact number (Home) *
Mobile Number *
Emergency Contact Number *
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