Membership Application Form

HUMAN RIGHTS YOUTH FEDERATION

Membership Application
Name

First NameLast Name
Father Name

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Education
Occupation
Blood Group
Hobbey
Adhar Number
E-mail
example@example.com
Mobile Number
Upload Photo

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Signature

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Signature Date

MonthDayYear
Date
Membership Type
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1 Year Membership
500.00INR

5 year Membership
1,000.00INR
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