Registration Form

Selfie Self-Free Shibir (15 -17 Aug)

Photograph *

Name *

Gender *

Male

Female

Age *

Address *

Mobile *

Emergency Contact *

Relationship with Emergency Contact *

Email *

Marital Status *

Married

Unmarried

Education *

Occupation *

Arrival Date *

Departure Date *

Have you participated in any such shibir / program before *

Yes

What do you expect from this shibir

Is there any specific subject / topic that you wish to learn about

Important information:

Shibir Norms:

All Shibirites are requested to adhere to the following norms:

Please reach the shibir venue one day prior to the shibir date before 6.00 pm
You may depart from the shibir venue on the next day of completion of the shibir after 7:00 am
Please carry your Aadhaar Card, Driving License or any other authentic address proof for registration.
Wearing the Shibir ID card is a must throughout the shibir.
Dress code: White and White, decent outfit.

Rupayatan Rd, Bhavnath, Junagadh Gujarat 362004

Please contact shibir co-ordinators for any questions @ +91 7303000555

I Agree To Dos/Don’ts/Rules/Guidelines *