Nexora Pathak
Member Registration Form
Membership Details
Registration Number
*
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only if you are joining in the current year.
Year Joined
2013
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2026
Batch
Regular
Weekend
Select Regular for daily practice or Weekend for weekend batch.
Full Name
Gender
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Male
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Other
Date of Birth
Instrument
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Dhol
Dhwaj
Tasha
Volunteer
Zanj
Contact Information
Phone Number
WhatsApp Number
Email Address
Blood Group
Select Blood Group
A+
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B+
B-
AB+
AB-
O+
O-
Address
Emergency Contact
Emergency Contact Name
Emergency Contact Number
Account Details
Profile Photo
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Password
Minimum 8 characters.
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