NAME : FATHERS NAME : DATE OF BIRTH : AADHAR CARD NO : VOTER ID CARD NO : ASSEMBLY CONSTITUENCY : MOBILE NO : EMAIL ID : ADDRESS : H.NO : STREET NAME : CITY NAME : STATE NAME : COUNTRY NAME : WOULD YOU LIKE TO TELL US MORE ABOUT YOU? I AGREE : I am above 18 years and not enrolled as a government employee. I am not a member of any other political party registered with the Election commission of India. I am not a member with any organization whose views, policies or actions are in conflict with the objective of the party. I have not been convicted of any offence involving moral turpitude. I Hereby consent to receiving any communication from the party either in writing, electronically and / or in any audio-visual format via phone [including SMS/MMS] email and / or at my address.