Official – DRASHTA Foundation

Member Form

First Name

Father/Mother's Name

Age

Last Name

Blood Grup

Address

Address Line 1

Address Line 2

City

State / Province / Region

Zip / Postal Code

Country

Image Upload

Drop your file here or click here to upload You can upload up to 1 files.

MP Constituency

MLA Constituency

Block

Ability

Specialization

Bussiness

AdhaarN0.

Contact N.

mailD

Purpose of joining the organization (150 words)

If you have been employee of the Government, then write your Designation

Are you member of Municipal corporation/ Panchayatiraj / MP/MLA Or have been in Past

Are you a member of any political party / organization.( Name of the party /NGO)

Have you been convicted by court of any crime ? yes/No If yes, Attach affidavit.

Declaration *

I …………………………………………………declare with sound mind that the above information given by me is true. As a member, I shall abide by the disciplinary rules and regulation enforced by the society. Considering the Indian constitution a witness, I promise to participate in the public interest campaigns of the organization with truthfulness.

Resume Upload

Drop your file here or click here to upload You can upload up to 1 files.

Date / Time

Phone