West Bengal Human Rights Commission

Please read all the instructions given herein (Click the link) before filling-up the form. This form will remain available till 23.3.2017. This form will not be available from 24.3.2017 to 27.3.2017 for maintenance purpose. It will be again available from 28.3.2017. For e-signature press left button of mouse and use it as pen. Please ignore the strike through in Captcha write the word beyond strike through in the text box below.The applicants are requested not to submit duplicate application form. A receipt of your application will be sent to your mail address submitted here. In case of any problem please mail to wbhrchgv@gmail.com or WhatsApp at 8585824919.

Link for Instruction.

Upload your passport size photograph 3.5 cm X 4.5 cm, withName and Date.

Name*

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Districts*

Police Station*

Mobile Number*

Area CodePhone Number

E-mail*

Date of Birth*

MonthDayYear

Gender*

Father's Full Name

Mother's Full Name

Occupation*

Aadhar No./EPIC No.*

PAN No.

Marital Status

No. of Dependents *

Monthly Income (Rs.)

Educational Qualification*

Others Qualification (if any)

I hereby declare that :

1. I was never arrested nor was involved or required in any criminal proceeding nor do I have any Criminal Case pending against me. (In case the answer is in the affirmative, please furnish particulars).

2. I am not a member of any political party.

3. I am not a member of any banned or prohibited gruop.

4. I am a permanent resident of jurisidication of above mention police station.

5. I am willing to render service as a Volunteer free of cost to WBHRC.

6. I have internet connection and Computer available with me.

* I solemnly affirm/swear in the name of God that I shall take steps to uphold the provisions of the Protection of Human Rights Act, 1993.

Please put your e-Signature by clicking left mouse button and using as pen.*

Declaration:

I solemnly declare that all the statements made in this application are true, complete and correct to the best of my knowledge and belief. In the event of any information being found suppressed/false or incorrect, or if my ineligibility is detected before, during or after enrolment, my candidature shall stand cancelled and I shall forfeit my right to act as a volunteer. I also declare that I have not applied earlier nor was my application rejected.

I accept.*

Please click the tick if you accept.

Please put your e-Signature*

Enter the word beyond strike through in the TextBox Below.*

Submission of multiple forms may result in rejection of your form.