Malisaini Priviledge Card : Basic Details

Permanent Address
Postal AddressSame as Permanent Address
Declaration :
I, Certify that the entries made by me in the Priviledge Card Application from are correct. In case of any discrepancy, the Priviledge Card / Application Form may be canceled and I am fully responsible for all liabilities. I Shall abide all the rules and regulations of the Priviledge Card Programme.
Please check your entries twice before submitting
because you will not be able to edit these entries once clicked 'Next'.
Application No.
Applicant Email
Application No.
Applicant Email