PHASE - 6, TPVPA REGULAR MEMBERSHIP REGISTRATION FORM

PHASE 1 - TPVPA SWARAKSHA PARIVAR REGISTRATIONS
NOTE: UPLOAD PROPER ID PROOF AND STRAIGHT LOOKING PASSPORT PHOTO(WITHOUT GOGGLES AND CAP). APPLICATIONS WILL BE REJECTED IF THEY ARE NOT PROPER.
District *
Enter your district of work. This wil help sort out forms district wise.
Full Name *
Birth Date :*

DayMonthYear
upload Passport Photo *

Browse Files
Note: If passport photo is not proper application will be rejected. Upload passport photo 35mm x 35mm with black stroke will be good. File size not more than 1mb. Cancelof
Upload your ADHAAR / ID PROOF*

Browse Files
Note: If Id proof is not proper application will be rejected. Upload front and back of your aadhaar card. File size not more than 1mb. Cancelof
MarriedUnmarried
Wedding Day:

MonthDayYear
E-mail*
example@example.com
Phone Number*
Whatsapp Number*
You will be added in official TPVPA SWARAKSHA whatsapp group
Alternate Phone Number
Blood group
If you don't know your blood group please leave this field.
Studio- Photography - Organisation Name
Nominee Full Name*
Nominee Relation*
Nominee Phone Number*
Nominee Passport Photo *

Browse Files
Note: If passport photo is not proper application will be rejected. Upload passport photo 35mm x 35mm with black stroke will be good. File size not more than 1mb. Cancelof
Nominee Bank Details

Amount will be transferred to below mentioned Nominee's Bank Account in case of Member's demise.
Nominee's Name as in Bank account*
Name of the Bank*
Bank Account Number*
Branch*
IFSC CODE*
Residence Address:*

Door/H.No

Street Address

DistrictState

Pin code
Office Address:

Door/H.No

Street Address

DistrictState

Pin code
Upload your association Id card *

Browse Files
Upload front and back of your association card. File size not more than 1mb. Cancelof
President or Gen Secretary Phone Number*
If you do not know leave this field
Upload Nominee's ADHAAR / ID PROOF*

Browse Files
Note: If Id proof is not proper application will be rejected. Upload front and back of your aadhaar card. File size not more than 1mb. Cancelof
Signature*

Clear
Once you submit your application, we will contact you shortly to complete your membership application.

Thank you!
Membership Fees
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Swaraksha Parivar Membership Fee1.00INR

Total 0.00INR
Should be Empty:

PHASE 1 - TPVPA SWARAKSHA PARIVAR REGISTRATIONS

Nominee Bank Details