Preliminary registration

Member details registration

Purpose of collecting information

This information is collected to obtain prospective member details.

Privacy notice

We are committed to protecting your privacy. Except where disclosure is required by law, personal information submitted here will not be provided to another party without your written consent.

Important note

This form collects preliminary details for the proposed association. Submitting it does not automatically grant official membership.

Personal information

* Fields marked * are required.

Full name *

NIC number (optional)

Date of birth (optional)

Full address *

District *

Divisional Secretariat Division *

Occupation or profession

Contact information

Contact number *

WhatsApp number Same as contact number

Email address (optional)

Participation and contribution

Support expected from the association

How you may contribute to the association

Willing to join district or regional activities? *

Yes No

May we contact you when official membership opens? *

Yes No

Personal information

Contact information

Participation and contribution

Consent and declaration