Consumer Club Registration
(Marked * are mandatory)
Name of the District*	--Select District--
Name of the Taluk*	--Select Taluk--
Name of the Educational Institution *
Full Address of the Institution*
Type of Educational Institution*	--Select Institution Type--
Name of the Principal/Head Master of Educational Institution*
Teacher Co-ordinator :
Name*
Mobile*
Student Co-ordinator :
President Name
Secretary Name
Treasurer Name
No of Members Enrolled in Citizen Consumer Club*
Is there a Club Display Board in front of the Institution?	Yes      No
Date of inauguration of Citizen Consumer Club*
Contact Phone No*
Contact E-Mail ID*
Citizen Consumer Club Website
Login Id Required to enter Monthly Developments*
Password*
Confirm Password*

 

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