Blind Graduate's Forum of India Membership Form
To
The Hon-Secretary
BLIND GRADUATES FORUM OF INDIA
Dear Sir/Madam
I am in agreement with the aims and objectives of BLIND GRADUATES’ FORUM OF
INDIA and agree to abide by its rules and regulations made from time to time. My personal
details are as following –
* Required
Name
*
Your answer
Current Address
*
Your answer
Permanent Address(Write "Same as current address" if same as current address.)
*
Your answer
Mobile Number
*
Your answer
Landline Number
Your answer
Email ID
*
Your answer
Date of Birth
*
MM
/
DD
/
YYYY
Gender
*
Female
Male
Marital Status
*
Single
Married
Divorced
Widowed
Do not wish to disclose
Nature of Blindness
*
Totally Blind
Partially blind
Night blindness
Color blind
Sighted
Cause of blindness
Your answer
Age at which blindness occurred
*
Your answer
Any other illness or disability
*
Your answer
Educational Qualification (mention if any specialization done)
*
Your answer
Braille knowledge
*
Can read and write braille
can only read braille
Don't know Braille
Languages Known
*
Your answer
Any special skills, aptitude, etc.
Your answer
Extra-curricular Activities
Your answer
Occupation Details
*
self-employed
professional
working in public sector
working in private sector
unemployed
Enroll me as
*
Life Member (Rs. 105)
ordinary member (Rs. 15) for yearly membership ending 31st December
associate life member (Rs. 105)
associate member (Rs 15) for yearly membership ending 31st December
*
I am in agreement with the aims and objectives of BLIND GRADUATES' FORUM OF INDIA and agree to abide by its rules and regulations made from time to time.
Required
Submit
Never submit passwords through Google Forms.
Forms
This content is neither created nor endorsed by Google.
Report Abuse
Terms of Service
Privacy Policy