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Registration Form
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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 *
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.
   
 
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