Join Us - Children India Foundation

Children India Foundation

Online Membership/Internship Form
Date of Application

DayMonthYear
Date
Time AM/PM Option
Applying as*

MembershipInternship

Type of Membership*

Lifetime MembershipGeneral MembershipStudent MembershipAffiliated Membership

Subscription

Rs. 10000 at the time of Joining & Rs. 500 per month
Subscription

Rs. 100 at the time of Joining & Rs. 100 per month
Subscription

Rs. 50 at the time of Joining & Rs. 20 per month
Subscription

Rs. 500 at the time of Joining & Rs. 200 per month
Name of the Institute/Organization *
Address*

Street Address

Street Address Line 2

CityState

Postal CodeCountry
Contact Number*
Email*

Confirmation Emailexample@example.com
Registration No. / Affiliation No.*
Contact Person*

PrefixFirst NameLast Name
Contact No.*
Email*
example@example.com

Personal Details
Name*

PrefixFirst NameLast Name
Father's/ Mothers' Name*

PrefixFirst NameLast Name
Gurdian's/ Husband's Name*

PrefixFirst NameLast Name
Date of Birth*

DayMonthYear
Date
Gender*

MaleFemaleOther
Civil Status*

MarriedUnmarried
Address*

Street/ Vill./ Locality

Land mark

CityState

Postal CodeCountry
Contact No.*
Please enter a valid phone number.
Alternative Contact No.
Please enter a valid phone number.
Email*

Confirmation Emailexample@example.com

Educational Details
Highest Qualification*
Enter Highest Qualification
Details of Educational Qualification*

Details of Extra-Curricular Activities
Extra-Curricular*

DanceMusicPaintingGameOthersN/A
Enter Details of Extra-Curricular Activites
Please Enter Details

Other Information
How do you help us*

As VolunteerAs DonorAs EducatorAs Content WriterSocial MarketingOther
If others, Kindly Spacify

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