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NATIONAL ORGANIC REVOLUTION
NATIONAL ORGANIC REVOLUTION

REgister nOw

Information for Admin

Registration Date

Introducer Name

Mobile No

Personal Detail

First Name *

Mobile No *

DOB *

State *

Pin No.

Last Name *

WhatsApp Moblile No

Address *

District

PAN Card No. *

Email Id

Sex *

Country *

City / Taluka

Adhar Card No.*

Nominee Detail (Note : *Nominee’s age Must be above 18.)

Nominee Name *

Relation *

D.O.B.

Account Detail

A/C Name

Bank Name

A/C No

IFSC Code

Confirm A/C No

Bank Address

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