Language
English (US)
Hindi
Registration Form
WhatsApp Chat: 8750942330 I Email: iadoptapencil@gmail.com I Web: www.adoptapencil.org I UPI: merchant767939.augp@aubank
Click to open form...
Your Referral ID (आपके परिचयकर्ता की ID)
Leave blank if not available (यदि नहीं है तो खाली छोड़ें)
Back
Next
Save
Your Name (आपका नाम)
*
Write full name (पूरा नाम लिखें)
Your WhatsApp Number (आपका वाट्सएप नंबर)
*
To send registration confirmation (पंजीकरण की पुष्टि भेजने के लिए)
Your Address (आपका पता)
*
City
State
Pin Code
Name of Child?
*
First Name
Last Name
Date of Birth of Child
*
-
Day
-
Month
Year
Date
Relation with Child
*
Please Select
SON
DAUGHTER
GRAND SON
GRAND DAUGHTER
OTHER
Your Contribution for Students
*
1 Student Support Sankalp – ₹50
3 Students Support Sankalp – ₹100
5 Students Support Sankalp – ₹200
Free Sankalp – First Time Only
Other
Upload Screenshot of Payment, send UPI at: merchant767939.augp@aubank
Browse Image
Drag and drop files here
Choose a file
Leave blank if no contribution
Cancel
of
UPI Txn. ID (last 4 digits): (Required for Educational Scholarship)
Leave blank if no contribution
Date of Contribution (Required for Educational Scholarship)
-
Day
-
Month
Year
Leave blank if no contribution
Select your Event (Any One)
*
Please Select
बुद्धि–सिद्धि संकल्प पाठ - श्री गणपति अथर्वशीर्ष पर आधारित
बाल विद्या संस्कार यज्ञ - श्री गणेश एवं माँ सरस्वती पर आधारित
Select Date of Event
*
-
Day
-
Month
Year
Date
I understand that this contribution is for welfare of needy students
*
Yes
Save
Submit
Should be Empty: