LIONS DISTRICT 321A2
DG VINEET GOYAL PMJF 2024-25

Club Officer's Registration Form

* indicates required fields

Club Name*
Your First Name*
Your Last Name
Membership No
Your Mobile No*
Your Email*
Your Date of Birth
Your Designation*
Spouse Name
Spouse Date of Birth
Wedding Anniversary Date
Postal Address
Your City*
Your Pincode
Your Photo*
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Are You Attending PST Schooling? * Yes No

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