Membership Application Form
Personal Details
Sponser Code
Full Name
Date Of Birth
Gender
Male
Female
Other
User Image
Preview
Marital Status
Single
Married
Other
Father's/Husband's Name
Residential Address
District
State
Pin code
Mobile
Alternative Mobile Number (If Any)
Email ID
Password
Password again
Identification Details
Aadhar Card Number
Voter ID / Other ID (If applicable)
Occupation / profession
Monthly Household Income (approx)
Nominee Details
Nominee Name
D.O.B.
Relationship
Membership Type Requested (Tick One)
General Member
Beneficiary Member (Low-Income / Below Poverty Line)
Donor Member
Volunteer Member
Purpose of Joining Sulabh Mart
Access to affordable essential goods
Willing to volunteer support the foundation
To support community welfare initiatives
Other
Declaration
I hereby declare that the above information is true and correct to the best of my knowledge, I agree to abide by the rules and regulations of Sulabha Mart and Mo Seva Sansthan Foundation (Mentioned overiral). I understand that membership privileges may be revoked in case of any false information or misase of benefits.
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