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Registration Form
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› Registration Form
Indian Nationals and Nationals of Indian Origin (OCI and PIO card holders) are requested to register with the Representative Office of India, State of Palestine .
I hold
Indian Passport
OCI Card
PIO Card
Palestinian Passport
I am on visit
I am permanent resident in Palestine
Gerneral Informations
Gender
Male
Female
Surname
*
Name
*
Date of Birth
*
Your age must be 18.
Country of Birth
*
Please select
India
Germany
Europe
Others
Contact in Palestine
Street
Postal code
City
*
State
*
Telephone
mobile_number
*
Email
*
If you are a visitor
Date of Arrival
*
Date of departure
*
Contact No in case of emergency
Passport No
*
Valid until
*
Present Status
I am
Student
Employed
Not employed
Minor
University / Institution / company
I have no objection to sharing my personal data
With everyone who may be interested
With other Registered members only
With the Embassy/Consulates only
Verification Code
*
Please, enter the text shown in the image into the field above.