Member Registration Form

Enrolment No
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Full Name
Type Your Full Name
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Short Name of Advocate
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Local Language
  • - select a option -
  • Odia
  • Hindi
  • Telugu
  • English
  • Tamil
  • Kanada
- select a option -
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Date of Birth
Select a date
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Gender
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Address of the Advocate
Type Your Address..
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Address of Advocate in Local Language
Type Your Address..
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Your Mobile Number
Mobile Number
Please Type 10 digit mobile number
Email
Your E-mail Address
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Whtatsapp Number (if Any )
Whtatsapp_Number
Please Type 10 digit mobile number
Your Landline Number
Landline_Number
Please Type 10 digit mobile number
Pin Code
Pin code
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Fax No
Enter Fax Number
Please Type 10 digit mobile number
District
District
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Office Address of Advocate where he practices
Office Address of Advocate where he practices
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Enter Taluka
Enter Taluka
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Type Of Advocate
  • - select a option -
  • Individual
  • Firm
  • Company
- select a option -
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Office Address of Advocate in Local
Office Address of Advocate in Local
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If Firm or Company,Registration No. in BCI
If Firm or Company,Registration No. in BCI
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Upload your Passport Photo ...
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