सदस्यता आवेदन पत्र / Official Membership Form

Membership Registration Application

Online Membership Registration for Dr. Mahesh Singh Sengar Jankalyan Samiti. Actively participate in grassroots social welfare, public education, healthcare, and humanitarian initiatives.

Applicant Details / आवेदक विवरण

Fields marked with an asterisk (*) are mandatory.

Official & Verified Application

1. Select Membership Category / सदस्यता श्रेणी चुनें *

Patron Member संरक्षक सदस्य

₹25,000 Lifetime Validity

Permanent voting rights, Advisory board membership, Special event honors

Life Member आजीवन सदस्य

₹11,000 Lifetime Validity

Lifetime membership certificate, ID card, Participation in general body meetings

Annual Member वार्षिक सदस्य

₹1,100 1 Year

Annual membership card, Regular newsletter, Volunteer opportunity privileges

Youth / Student Member युवा / छात्र सदस्य

₹500 1 Year

Skill development workshop invites, Youth leadership mentorship, Certificate

Honorary Member मानद सदस्य

₹0 Lifetime Validity

Nominated by executive committee for outstanding social contributions

2. Personal Details / व्यक्तिगत जानकारी

Full Name (English) *

Full Name (Hindi) / पूरा नाम (हिंदी)

Father's / Husband's Name / पिता या पति का नाम

Occupation / व्यवसाय या पेशा

Date of Birth / जन्म तिथि

Gender / लिंग *

Mobile Number / मोबाइल नंबर *

Email Address / ईमेल पता

3. Address & Jurisdiction / पता एवं शाखा

Full Residential Address / स्थायी पता *

State / राज्य

District / ज़िला *

Branch / शाखा कार्यालय

4. Photographs & Verification Documents / फ़ोटो एवं पहचान प्रमाण

Profile Photograph / पासपोर्ट साइज फ़ोटो

Square headshot for digital membership ID card (JPG, PNG, max 2MB).

Identity Document (Optional) / पहचान पत्र (वैकल्पिक)

Aadhaar / Voter ID / Driving License (PDF, JPG, PNG, max 5MB).

I hereby declare that the information provided above is true and correct to the best of my knowledge. I promise to abide by the rules, code of conduct, and core objectives of Dr. Mahesh Singh Sengar Jankalyan Samiti.

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