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Sample Form: عضویت در باشگاه مشتریان

ثبت‌نام باشگاه وفاداری با شماره موبایل، تاریخ تولد برای هدیه‌ی تولد و علاقه‌مندی‌ها.

6 questions · Free up to 50 responses a month

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About this template

“عضویت در باشگاه مشتریان” has 6 questions; 3 are required and 3 optional. Question types: Short text (1), Mobile number (1), Date (1), Dropdown (1), Multiple choice (1), Accept the terms (1). 8 ready-made options across 2 choice questions, all editable in the online version.

In the online version of this template

  • Mobile numbers are validated against the Iranian number format.
  • Dates are picked and stored on the Jalali (Persian) calendar.
Related:Online form builder

Questions in this template

  1. 1.

    نام و نام خانوادگی *

    (Short text)
  2. 2.

    شماره موبایل *

    (Mobile number)
  3. 3.

    تاریخ تولد

    (Date)

    برای هدیه‌ی تولد

  4. 4.

    جنسیت

    (Dropdown)
    • زن
    • مرد
    • ترجیح می‌دهم نگویم
  5. 5.

    علاقه‌مندی‌ها

    (Multiple choice)
    • پوشاک
    • لوازم خانگی
    • دیجیتال
    • کتاب
    • غذا
  6. 6.

    با دریافت پیامک تخفیف موافقم *

    (Accept the terms)

Printable or online?

Printable version (Word & PDF)

  • For filling in on paper, signing and filing by hand
  • Edit the Word file any way you like
  • Collecting and typing up the answers is up to you
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Online version on Porsino

  • Answers are collected and organised automatically — no retyping
  • National ID, mobile number and dates are validated instantly
  • Ready-made reports and charts, plus Excel export in one click
  • Share a link or QR code — it works on mobile too
Build the online version for free

How do I use this template?

  1. Sign up for Porsino for free; no bank card needed.
  2. In the panel, open “Templates” and choose “عضویت در باشگاه مشتریان”.
  3. Change the questions as you like, publish the form and send the link.

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