Membership Form
(* Required)
District
Anugul
Boudh
Bhadrak
Balangir
Bargarh
Balasore
Cuttack
Deogarh
Dhenkanal
Ganjam
Gajapati
Jharsuguda
Jajapur
Jagatsinghapur
Khordha
Keonjhar
Kalahandi
Kandhamal
Koraput
Kendrapara
Malkangiri
Mayurbhanj
Nabarangpur
Nuapada
Nayagarh
Puri
Rayagada
Sambalpur
Sonepur
Sundargarh
Block
Constituency
Full Name
*
Age
*
Contact number
*
Voter Id
Father / Mother / Husband
Full address
E-mail ID
Can you be a volunteer
Yes, Please
No, Sorry
Gender
*
Male
Female
Pin Code
Educational Qualification
Work Experience
Do you have a laptop that you can use ?
Yes
No
Would you be able to travel within your city ?
Yes
No
Would you be able to travel to places other than your city ?
Yes
No
Personal vehicle that you can use ?
Yes
No
Vehicle type
Two wheeler
Four wheeler
How can you help us?
*
(Kind of Engagement)
Field Work
Social Media
Data Entry / Typing
Material/Graphic Designing
Calling Campaign
Media Relationship
Fund Raising
Volunteers Management
Website Management
Office Management
Logistics
Legal Team
Bike Rallies
Flash mob/Skits
Making Phone calls
Documenting
Answering Phone calls
Receiving office visitors
Software Programming
Writing skills
Donor Mobilization
Event co-ordination
Door to door campaigning
Creative Arts (Poet/Singer/Theatre)
Media Monitoring (TV/Newspaper/Magazines)
Responding to letters/Emails in office
Trainers
Security
Camera Skills
Video Editing
Research
Translation (Language)
Provide space for party office
Other :
How much time you can give for ground campaigning?
*
Full Time
Morning till 8 AM
Evening from 6 PM
Once a week
1/more hour/s in a day
Only Weekend (Saturday & Sunday)
Occasionally
Other :
Any suggestions ?
