NBA / NIBA Registration Form Personal Information Full Name Age Gender Male Female Other Date of Birth Mobile Number WhatsApp Number Email Address Details Full Address City / Town District State PIN Code Education & Background Highest Qualification 10th Pass 12th Pass Diploma Graduate Postgraduate Other Are you associated with Nepathya? Current Student Former Student Not Associated NBA / NIBA Category Select Associate Type NBA – Nepathya Business Associate NIBA – Nepathya Independent Business Associate Network & Promotion Details How do you plan to promote Nepathya? Friends & Family Network Social Media Local Community Schools / Colleges Women Self Help Groups Other Estimated Network Size: 50 – 100 100 – 300 300 – 500 500+ First Month Performance Goal Walk-in Goal 30 Walk-ins 60 Walk-ins 100 Walk-ins Admission Goal 1 – 5 Admissions 6 – 10 Admissions 11 – 15 Admissions 16 – 20 Admissions 21 – 25 Admissions 26 – 30 Admissions Registration Fee Payment Mode Cash UPI Bank Transfer Emergency Contact Emergency Contact Person Relation Mobile Number Declaration by Applicant I hereby declare that: All the information provided by me in this form is true and correct. I understand the roles, responsibilities, and incentive structure of the NBA / NIBA Program of Nepathya Fashion Design Academy & Boutique. I agree to follow the guidelines and ethical practices while promoting Nepathya. I understand that incentives and bonuses will be awarded only after the successful generation of verified walk-ins or confirmed admissions. I acknowledge that the ₹500 registration fee will be refunded only after achieving the first performance goal as defined in the program. I agree to work responsibly and represent Nepathya with honesty, respect, and professionalism. Submit
