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Registration Form

The Indian nationals who are residing in the jurisdiction of AHCI Kandy (Central Province, Sabaragamuwa Province, Uva Province and Kurunegala Dist. of North Western Province) are advised to register themselves with the AHCI Kandy in the following prescribed proforma.

First Name*
Last Name*
Date of Birth*
Location*
State*
Phone Number*
Mobile Number*
Profession:*

 
Email ID*
Passport Number*

Address in Kandy, Sri Lanka.


 


Address Line 1*
Address Line 2
State*
Phone Number*

Address in India


 


Address Line 1*
Address Line 2
State*
Phone Number*

Contact Person In Kandy, Sri Lanka.


 


Name*
Address*
Mobile Number*
Phone Number*
Email ID*
Date of Arrival in Kandy*
Expected duration of stay
(in numbers)*

Contact Person In India


 


Name*
Address*
Mobile Number*
Phone Number*
Email ID*
Purpose of Visit*
Current Location/city/town*
 

 

Registration Form