Viyathmaga Membership Application Form
එන්න අප හා එක්වන්න! දක්ෂ නායකයෙක් යටතේ වැඩ කරමු! අපි එකතු වී අපේ රට සංවර්ධනය කරමු!
PERSONAL DETAILS
Title: *
Full Name: *
Your answer
LinkedIn Profile (URL)
Your answer
Facebook Profile (URL)
Your answer
Gender: *
Age: *
CONTACT DETAILS
Postal Address:
Your answer
Mobile Number: *
Your answer
Mobile Number:
Your answer
Email: *
Your answer
District: *
Divisional Secretariat:
Your answer
Country (If you are living outside Sri Lanka)
Your answer
PROFESSION
Classification: *
Required
Current Employer *
Your answer
Current Job Position *
Your answer
Education Qualification *
Education Qualification (Specify) *
Your answer
Profession: *
REFEREE'S DETAILS
The name & the contact number of the person you introduced to Viyathmaga.
Name:
Your answer
Contact Number:
Your answer
CONSENT
Active Participation: *
Your active participation in organizing meetings, policy planning, membership drive & communication.
How would you like to contribute to Viyathmaga :
Your answer
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Required
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Required
We assure that your data will not be shared with anyone without your consent.
Viyathmaga Secretariat
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