<%@ Page Language="C#" AutoEventWireup="true" CodeFile="Register_Advocates.aspx.cs" Inherits="Register_Advocates" %> <%@ Register Assembly="System.Web.Extensions, Version=1.0.61025.0, Culture=neutral, PublicKeyToken=31bf3856ad364e35" Namespace="System.Web.UI" TagPrefix="asp" %> <%@ Register Assembly="AjaxControlToolkit" Namespace="AjaxControlToolkit" TagPrefix="cc1"%> CITIZEN FORCE FOUNDATION FOR CITIZENS

ADVOCATE Registration


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YOU CAN EDIT FROM TIME TO TIME THE INFORMATION PROVIDED HERE IN CERTAIN FIELDS AT ANY TIME THROUGH "LOGIN"
     
Contact / Office / Residence Address* : Residence Office Residence-Cum-Office
Pincode* :
State* :
Session Expires by
 seconds.  
District* :
Mandal / Taluk* :
Post Office Name* :
City / Town / Village*  
Salutation* :
Gender* :
Date Of Birth : <%-- --%> <%--
Select --- Select --- January February March April May June July August September October November December
Age* :
Name* :
Surname* :
Bar Council Reg. No* : (Ex: AP/9/1999)
Your Personal Mobile number (This will be your Login ID and to receive/retrieve forgot password)* : (Password will be sent to this mobile)
Conform Mobile number* :
Email address* :
Confirm Email address* :
Do you wish to be a Primary Volunteer?* :
Yes No
Do you wish to disclose Your Identity as a Primary Volunteer?* :
Yes No
BLOOD GROUP* :

Are you interested in BLOOD DONATION in case of emergency to anyone? * :
Upload Photo :
Form Filled By* :
    Privacy statement 
Security Code* :
Enter Security Code* :
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