Member Registration

Member/Non-member Code
Member/Non-member Name *
Is Member Is Executive Member(Yes/No)
Is Govt. Member

Address Details

Village/Street *
P.O. *
P.S. *
PIN *
State *
District *
Block *
Plot No.
Khaitan No.
Mouza
JL No.
Personal Details

Mobile No.
Alternative Mobile No. (not for SMS)
Phone No.
Email
VAT No.
PAN No.
LIC No.
GST No.
Photo
Select Photo
Capacity

Layer Capacity (Nos)
Breeder Capacity (Nos)
Chicken Seller Daily Sales (Nos)
Feed Producer Daily Sales (MT)
Broiler Capacity (Nos)
Egg Seller Daily Sales (Nos)
Chicken Seller Daily Sales (Kgs)
Feed Seller Daily Sales (MT)
Other Category
Remarks
Business Details

Company Name
Website
Membership Category *
Member Group
Membership Category Effective Date *
Business Type
Membership Date *
Effective Date *
Narration
Member SMS Category

Document Details

Document 1
Document 2
Document 3