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Personal Details
Name
*
Mobile number
*
Whatsapp number
*
Same as Mobile Number
Email
*
Gender
*
Male
Female
Other
Age
*
Choose Age
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
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76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
Educational qualifications
*
Select Your Educational qualifications
Below 10th Standard
10th Standard
12th Standard
Graduate
Post Graduate
Occupation
*
Choose Your Occupation
What is your occupation from the following?
Choose Your Occupation
Shopkeeper
Contractor
Farmer
Business
Other
Which category do you belong to?
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Choose Category
State
*
Select State
District
*
Select District
Assembly Constituency
*
Select Assembly Constituency
Do you reside in a village or a city?
*
Village
City
Block
Select Block
Name of your Gram Panchayat?
Select Gram Panchayat
City Name
Select City
Political Insights
Are you associated with any party, currently?
*
Choose Party
Are you a party post holder?
Select your position
District President
District Vice President
District Secretary
District General Secretary
Block President
Block Vice President
Block Secretary
Block General Secretary
Frontal District President
Frontal District Vice President
Frontal District Secretary
Media Cell
Booth Worker
Other
Whom do you want to support?
Prashant Kishor
I-PAC
Youth in Politics
Social issue
How would you like to support the YIP network?
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