NAB
नेपाल नेत्रहीन संघ
केन्द्रीय कमिटी
NAB Membership Form
(सदस्यता व्यवस्थापन फाराम)
Please fill the required field.
(कृपया तलको फाराममा आफ्नो व्यक्तिगत विवरण सावधानी पूर्वक भर्नु हुन सम्बन्धित सम्पूर्ण महानुभावहरूमा हार्दिक अनुरोध छ ।)
First Name (पहिलो नाम):
Middle Name (बिचको नाम यदि छ भने मात्र):
Last Name (थर):
Gender (लिङ्ग):
Male (पुरुष)
Female (महिला)
Others (अन्य)
Date of Birth (जन्म मिति):
Year (साल):
Choose your year
2079
2078
2077
2076
2075
2074
2073
2072
2071
2070
2069
2068
2067
2066
2065
2064
2063
2062
2061
2060
2059
2058
2057
2056
2055
2054
2053
2052
2051
2050
2049
2048
2047
2046
2045
2044
2043
2042
2041
2040
2039
2038
2037
2036
2035
2034
2033
2032
2031
2030
2029
2028
2027
2026
2025
2024
2023
2022
2021
2020
2019
2018
2017
2016
Month (महिना):
Choose your month
Baishakh
Jeshtha
Ashadha
Shrawan
Bhadra
Ashwin
Kartik
Marga
Pousha
Magha
Phalguna
Chaitra
Day (गते):
Choose for Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Age (उमेर):
Choose yout Age
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
Ethnicity (जाति):
Choose your Caste
Khas Arya
Janajati
Newars
Madhesi
Marwadi Bengali Punjabi
Undefined
Caste (जाति):
Choose your Caste
Brahmin
Chhetri
Newar
Magar
Tharu
Tamang
Kami
Musalman
Yadav
Rai
Gurung
Damai
Thakuri
Limbu
Sarki
Teli
Chamar
Kushwaha
Musahar
Kurmi
Sanyasi
Dhanuk
Pasawan
Mallaha
Kewat
Kathbaniyan
Brahman Terai
Kalwar
Kanu
Kumal
Gharti
Hajam
Rajbansi
Sherpa
Dhobi
Tatma
Lohar
Khatwe
Sudhi
Danuwar
Haluwai
Majhi
Baraee
Bin
Nuniya
Chepang
Sonar
Kumhar
Sunuwar
Bantar
Kahar
Satar
Marwadi
Kayastha
Rajput
Badi
Jhangad
Gangai
Lodh
Badhaee
Thami
Kulung
Bangali
Gaderi
Dhimal
Yakkha
Ghale
Tajpuriya
Khawas
Darai
Mali
Dhunia
Pahari
Rajdhob
Bhote
Dom
Thakali
Kori
Chhantyal
Hyolmo
Bote
Rajbhar
Brahmu
Punjabi
Nachhiring
Yamphu
Gaine
Chamling
Aathpariya
Jirel
Dura
Sarbaria
Meche
Bantaba
Raji
Dolpo
Halkhor
Byasi
Amat
Thulung
Lepcha
Pattharkatta
Mewahang
Bahing
Natuwa
Hayu
Dhankar
Lhopa
Munda
Dev
Dhandi
Kamar
Kisan
Sampang
Koche
Lhomi
Khaling
Topkegola
Chidimar
Walung
Loharung
Kalar
Raute
Nurang
Kusunda
Foreigner
Other
Religion (धर्म):
Choose your religion
Hindu
Buddhism
Islam
Kirat
Christianity
Sikhism
Jainism
Bahai
Animism
Others
Mother Tongue Language (आफ्नो मातृभाषा):
Choose your Mother Tongue
Nepali
Maithili
Bhojpuri
Tharu
Tamang
Magar
Avadhi
Bajjika
Limbu
Sherpa
Gurung
Rai
Marital Status(वैवाहिक अवस्था)
Unmarried (एकल)
Single (एकल)
Married (विवाहित)
Widowed (एकल महिला)
Widower (विदुर)
Divorced (सम्बन्ध विच्छेद)
Spouse Name (पति वा पत्नीको नाम)(यदि उपलब्ध छ भने मात्र)
Father's Name (बाबुको नाम):
Mother's Name (आमाको नाम):
Qualification (आफ्नो शैक्षिक योग्यता)
Choose your qualification
Illiterate
Basic Level
SLC/SEE
Intermediate/+2
Bachelor
Master
MPhil
PhD
Training (तालिम)
Bamboo Stool Making
Knitting and Weaving
Phenyl Making
Soap Making
Music
Computer
Bee Keeping
Mushroom Farming
Animal Husbandry
Rope Making
Others
If other training please specifiy (यदि अन्य तालिम हो भने उल्लेख गर्नुहोस):
Are you Employed? (के तपाई रोजगारीमा हुनुहुन्छ?):
Choose your option
Yes
No
Employment Staus (रोजगारीको अवस्था):
Choose your option
Government Job
Private Job
Teaching Job
Business
Contact Number (सम्पर्क नम्बर):
E-mail Address(इ-मेल)
Permanent Address (स्थायी ठेगाना):
Province (प्रदेश):
Choose Your Province
Koshi Province
Madesh Province
Bagmati Province
Gandaki Province
Lumbini Province
Karnali Province
Sudur-Paschhim Province
District (जिल्ला):
Choose Your District
Local Level (स्थानीय तह):
Choose Your Local Level
Ward (वडा नं.):
Tole (टोल):
Current Address (हालको ठेगाना):
Province (प्रदेश):
Choose Your Province
Koshi Province
Madesh Province
Bagmati Province
Gandaki Province
Lumbini Province
Karnali Province
Sudur-Paschhim Province
District (जिल्ला):
Choose Your District
Local Level (स्स्थानीय तह):
Choose Your Local Level
Ward (वडा नं):
Tole (टोल):
Blindness
Choose your disability
Total Blind
Light Perception
Low Vision
One-Eyed
Deaf-Blind
No Disability
Other Disability
If Other Disability
Citizenship Number (नागरिता नं.)
Citizenship Issued (नागरिता जारी भएको):
Province (प्रदेश):
Choose Your Province
Koshi Province
Madesh Province
Bagmati Province
Gandaki Province
Lumbini Province
Karnali Province
Sudur-Paschhim Province
District (जिल्ला):
Choose Your District
National ID Card Number (राष्ट्रिय परिचय-पत्र नं.)
Disability ID Card Number (अपाङ्गता कार्ड नं.)
ID Card Type (अपाङ्गता कार्ड प्रकार)
Choose your Card Type
Red
Blue
Yellow
White
None
ID Card Issued
Province
Choose Your Province
Province 1
Madesh Province
Bagmati Province
Gandaki Province
Lumbini Province
Karnali Province
Sudur-Paschhim Province
District
Choose Your District
Local Level
Choose Your Local Level
Other Disabilities
Choose your disability
Physical Disability
Visual Disability
Hearing Disability
Deaf Blindness
Speech Disability
Mental or Psychosocial Disability
Intellectual Disability
Autism Spectrum Disorder
Hemophilia
Multiple Disability
None
Membership on NAB
Choose your Membership Type
General
Lifetime
Helping
Helping Lifetime
Donor
Honorary
Date of Membership
Choose your year
Lifetime
2079
2078
2077
2076
2075
2074
2073
2072
2071
2070
2069
2068
2067
2066
2065
2064
2063
2062
2061
2060
2059
2058
2057
2056
2055
2054
2053
2052
2051
2050
2049
Renew Upto
Choose your year
Lifetime
2079
2080
2081
2082
2083
2084
2085
Committed On
Choose your Committee
Central Committee
Province Committee
District Committee
Local Committee (Palika)
Audit Committee
Election Committee
Department
None
Designation
Choose your Designation
President
Senior Vice President
Women Vice President
Vice President
General Secretary
Secretary
Joint-Secretary
Treasurer
Member(Open)
Member(Woman)
Member(Dalit)
Member(Janajati)
Member(Madhesi)
Chief Audit Coordinator
Member(Audit Committee)
Chief Election Coordinator
Member(Election Committee)
Executive Advisor
Advisor
None
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Receipt No.
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