Membership – Join Basic Shiksha Foundation | Empower Education & Health in India

Full Name (As per Aadhaar) *

Father's / Spouse's Name *

Date of Birth *

Gender *

Nationality *

Mobile Number *

Alternate Mobile Number

Email ID *

Permanent Address (As per Aadhaar) *

Correspondence Address same as Permanent Address

Correspondence Address *

City / District *

State *

PIN Code *

Aadhaar Number * Enter 12-digit Aadhaar number

PAN Number Format: ABCDE1234F (5 letters, 4 digits, 1 letter)

Account Holder Name *

Bank Name *

Branch Name *

Account Number *

IFSC Code *

Type of Membership *

Membership Fee *

I hereby declare that the information provided above is true and correct. *

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