Tirtha Mitra - Kurukshetra Development Board

‘Tirtha Mitra’ Registration Form

Current Date *

Full Name *

Father's Name *

Contact Number *

Email Address

Date of Birth *

Field of interest

Name of Tirtha for Tirtha Mitra *

Details if associated with any Voluntary Organization

Temporary Address

Permanent Address *

Upload Recent Latest Photograph (Max 1 MB) *

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