Govt. Registration No.: IV-1804-00104/2025
1. Full Name
2. Father / Husband Name
3. Date of Birth
4. Gender Select GenderMaleFemaleOther
5. Mobile Number
6. Aadhaar / ID Number
7. Occupation
8. Full Address
9. District / State
10. Pin Code
11. Education Qualification
12. Joining Type
Select Joining TypeMemberVolunteerSupporter
13. Area of Interest
Select Area of InterestSocial WorkEducationWelfareMedicalOther
Declaration:
I hereby declare that the information provided by me is true and correct. I agree to follow the rules, discipline, and objectives of Maa Shakambari Sewa Samiti Welfare Trust.
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