Viyathmaga Membership Application Form

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

එන්න අප හා එක්වන්න! දක්ෂ නායකයෙක් යටතේ වැඩ කරමු! අපි එකතු වී අපේ රට සංවර්ධනය කරමු!

PERSONAL DETAILS

Title: *

Full Name: *

Gender: *

Age: *

LinkedIn Profile (URL)

Facebook Profile (URL)

CONTACT DETAILS

Postal Address: *

Mobile Number: *

Mobile Number:

Email: *

District: *

Divisional Secretariat: *

Country (If you are living outside Sri Lanka)

PROFESSION

Classification: *

Professional

Businessman

Entrepreneur

Other:

Required

Current Employer *

Current Job Position *

Education Qualification *

Education Qualification (Specify) *

Profession: *

REFEREE'S DETAILS

The name & the contact number of the person you introduced to Viyathmaga.

Name: *

Contact Number: *

CONSENT

Active Participation: *

Your active participation in organizing meetings, policy planning, membership drive & communication.

How would you like to contribute to Viyathmaga : *

I hereby confirm that above information are true and accurate.

Required

I hereby give consent to Viyathmaga to send me relevant updates via post, email and mobile messaging

Required

We assure that your data will not be shared with anyone without your consent.
Viyathmaga Secretariat

Submit

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy