Terai Madhesh National Council

Membership Form

Your Full Name *

Select Province *

Home District *

Municipality/VDC *

Are you in Nepal or abroad? *

Nepal Abroad

Your current address ? *

Phone number with country code *

Email *

Academic Qualification

Profession/Occupation *

Work Experience

How would you love to help us? *

Time

Funds

Your Network

Your Blood Group Type- Optional: for emergency purposes to help others we may contact you.

Select list:

Interests? *

Political Activities

Social Activities

Both

Why you want to join TMNC?

Facebook Profile.Link

Passport Size Photo

I agree all the terms and conditions.