Membership Registration Form
Your Name
*
Name is required.
Mobile Number
*
Mobile Number is required.
Enter valid 10-digit mobile number.
Email
Address (Village, District, State)
*
Address is required.
Membership Type
*
Select
Board Member
Premium Member
Gold Member
Silver Member
Working Member
Membership Type is required.
Combatant Status
*
Select
Combatant
Non-Combatant
Combatant Status is required.
Want Appointment/Post?
*
Select
Yes
No
This field is required.
Occupation
*
Select
GOVERNMENT JOB
RETIRED POLICE PERSONNEL
RETIRED DEFENCE PERSONNEL
PRIVATE JOB
BUSINESS
POLITICIAN
SOCIAL WORKER
PRIEST
UNEMPLOYED
STUDENT
FARMER
RETIRED FROM JOB
OTHER
Occupation is required.
Enter Amount
*
Amount is required.
Transaction ID
* All fields marked with
*
are mandatory