Membership Application

1. PERSONAL INFORMATION

Full Name *

Email Address *

Mobile Number *

Date of Birth

Gender

Father / Mother / Guardian Name

Occupation

Blood Group

Marital Status

Applicant Photo * Passport-size photograph. JPG or PNG only. Maximum 2 MB.

2. ADDRESS INFORMATION

Full Address

City / Town

District

State

Pincode

3. MEMBERSHIP DETAILS

Membership Type *

Areas of Interest

Education Health Environment Women Empowerment Youth Development Social Service Disaster Relief Other

Why do you want to join NSJF?

4. IDENTITY VERIFICATION

ID Proof Type

ID Proof Number

ID Proof Document JPG, PNG or PDF. Maximum 2 MB.

Other Document (Optional) JPG, PNG or PDF. Maximum 2 MB.

5. APPLICANT SIGNATURE

Upload Your Signature * Upload a clear image of your signature. JPG or PNG only. Maximum 2 MB.

Signature Instructions

Sign on a clean white paper using a dark pen, take a clear photograph or scan of the signature, and upload the image.

6. DECLARATION

I declare that the information provided by me is true and correct to the best of my knowledge.
I agree to abide by the rules, regulations and policies of Netaji Subhas Janakalyan Foundation.

Membership Application

Membership Application Form