Complete the form below for
Certificate of Participation
Surname:
Other Names:
Name of Centre:
State:
Caucus:
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South West
South South
South East
North West
North East
North Central
Designation:
Select
NOC
Extended NOC
Centre President
Centre Secretary
Past NARD Leader
Delegate
Mobile No (Whatsapp):
Email Address:
Mode of Transportation:
Select
Air
Road
Train
Date and Time of Arrival:
Date and Time of Departure:
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