సంఘకర్త రిజిస్ట్రేషన్ ఫారము

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Name / పేరు : *

Age / వయస్సు :
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Mobile number / ఫోన్ నెంబర్ :
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Education Qualification / విద్యా అర్హత :
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Gender / లింగము :
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Male

Female

Other

Occupation / వృత్తి :
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Village/Town - గ్రామము / పట్టణము :
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Assembly Constituency name / అసెంబ్లీ నియోజకవర్గం పేరు :
*

Chodavaram

Payakaraopet (SC)

Pendurthi

Narsipatnam

Elamanchili

Madugula

Anakapalli

Palakonda (ST)

Kurupam (ST)

Salur (ST)

Parvathipuram (SC)

Paderu (ST)

Rampachodavaram (ST)

Araku Valley (ST)

Srikakulam

Narasannapeta

Palasa

Tekkali

Ichchapuram

Amadalavalasa

Pathapatnam

Visakhapatnam North

Srungavarapukota

Bhimili

Visakhapatnam South

Gajuwaka

Visakhapatnam East

Visakhapatnam West

Nellimarla

Vizianagaram

Bobbili

Rajam (SC)

Etcherla

Cheepurupalli

Gajapathinagaram

Ramachandrapuram

P Gannavaram (SC)

Razole (SC)

Kothapeta

Mandapeta

Amalapuram (SC)

Mummidivaram

Tuni

Kakinada Rural

Pithapuram

Peddapuram

Jaggampeta

Kakinada City

Prathipadu

Tadepalligudem

Achanta

Palakollu

Bhimavaram

Narasapuram

Tanuku

Undi

Kovvur (SC)

Rajanagaram

Rajahmundry City

Rajahmundry Rural

Anaparthy

Gopalapuram (SC)

Nidadavole

Chintalapudi (SC)

Kaikalur

Unguturu

Denduluru

Eluru

Nuzvid

Polavaram (ST)

Puthalapattu (SC)

Chittoor

Kuppam

Chandragiri

Nagari

Palamaner

Gangadhara Nellore (SC)

Kavali

Atmakur

Udayagiri

Nellore City

Nellore Rural

Kandukur

Kovur

Darsi

Kanigiri

Yerragondapalem (SC)

Ongole

Kondapi (SC)

Giddalur

Markapuram

Rajampet

Punganur

Rayachoti

Thamballapalle

Madanapalle

Kodur (SC)

Pileru

Gudur (SC)

Tirupati

Venkatagiri

Sarvepalli

Srikalahasti

Satyavedu (SC)

Sullurpeta (SC)

Singanamala (SC)

Rayadurg

Uravakonda

Guntakal

Tadipatri

Kalyandurg

Raptadu

Anantapur Urban

Penukonda

Madakasira (SC)

Dharmavaram

Hindupur

Puttaparthi

Kadiri

Kamalapuram

Badvel (SC)

Kadapa

Pulivendula

Jammalamadugu

Proddatur

Mydukur

Kodumur (SC)

Pattikonda

Kurnool

Adoni

Yemmiganur

Alur

Mantralayam

Nandikotkur (SC)

Dhone

Nandyal

Srisailam

Panyam

Banaganapalle

Allagadda

Vemuru (SC)

Repalle

Bapatla

Parchur

Addanki

Santhanuthalapadu (SC)

Chirala

Prathipadu (SC)

Mangalagiri

Tadikonda (SC)

Ponnur

Tenali

Guntur West

Guntur East

Penamaluru

Gannavaram

Gudivada

Machilipatnam

Avanigadda

Pamarru (SC)

Pedana

Sattenapalle

Narasaraopet

Vinukonda

Macherla

Gurazala

Pedakurapadu

Vijayawada West

Tiruvuru (SC)

Vijayawada Central

Nandigama (SC)

Jaggayyapeta

Vijayawada East

Mylavaram

Chilakaluripet

Required

How many days can you spend / ఎన్ని రోజులు వెచ్చించగలరు :
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One week / ఒక వారము

Two weeks / రెండు వారాలు

Three weeks / మూడు వారాలు

Four weeks / నాలుగు వారాలు

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