Join AAM AADMI PARTY, Odisha

ସଦସ୍ୟତା ପଞ୍ଜିକରଣ ଫର୍ମ

Fill out the form below to register your membership. Fields marked with an asterisk (*) are required.

Full Name (ନାମ)*

Please enter your full name.

Mobile Number (ମୋବାଇଲ ନମ୍ବର)*

+91

Please enter a valid 10-digit mobile number.

Age (ବୟସ)*

Please select your age.

Gender (ଲିଙ୍ଗ)*

Please select your gender.

Father's Name (ପିତାଙ୍କ ନାମ)

Mother's Name (ମାତାଙ୍କ ନାମ)

District (ଜିଲ୍ଲା)*

Please select your district.

Assembly (ବିଧାନସଭା)*

Please select your assembly.

Ward(ୱାର୍ଡ)/ Panchayat(ପଞ୍ଚାୟତ)

Pincode*

Please enter your Pincode.

Address (ଠିକଣା)

Membership Type (ସଦସ୍ୟତା ପ୍ରକାର)*

Please select a membership type.

Voter ID Number (ଭୋଟର କାର୍ଡ ନମ୍ବର)

Aadhar Card Number (ଆଧାର କାର୍ଡ ନମ୍ବର)

Remark (ଆପଣଙ୍କ ମନ୍ତବ୍ୟ)

Form Fillup Type (ଫର୍ମ ପୂରଣ ପ୍ରକାର)*

Self-Filled (ନିଜେ ପୂରଣ କରିଛନ୍ତି) Assisted by Party Member (କର୍ମକର୍ତ୍ତାଙ୍କ ଦ୍ୱାରା)

Party Member Name (କର୍ମକର୍ତ୍ତାଙ୍କ ନାମ)*

Please enter the party member's name.

Party Member Number (ମୋବାଇଲ ନମ୍ବର)