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Membership Form

Any adult Indian citizen residing within the society's area of operation, who believes in its objectives, may apply.

Form No.

Date

Head of Family Name

Father's/Husband's Name

Gotra

Age

Mobile No.

Village/City

Ancestral Residence

Current Residence

Membership Tier

Sr.	Member Name	Status	Relation to Applicant	Age	Mobile No.
1

I and my family wish to become members of this society. We will abide by the society's rules; minimum age for membership is 18 years.