Name*
Company*
Area* Meeting-RoomActivity-HallBusiness-center
Date of Meeting*
Starting Time* [Hour* id-number]
Birth Place*
Occupation*
Mobile*
P.O.Box*
Your Email*
Required Period* One Year ( 60 QRs.)Two Years ( 120 QRs.)
Color Photo (accepted file types are: PNG,JPG and JPEG)*
I request your approval of my QYH membership. I hereby declare that all information provided in this form is correct. And I hereby declare that I have good conduct and have never issued any judgment against me in a crime involving moral misconduct. I also confirm that I have never lost my membership of any youth, cultural or social centers due to violating public order or cultural norm