Membership application form

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Membership application form

Personal Details

Name * settings

Gender * settings - Choose - Male Female Other

Photo settings

Fathers Name settings

Phone/Whtsaap * settings

Email * settings

Address from Hills settings

Current Address * settings near masseeh dilasa school , village tiloth ,

Membership Type settings From ₹100.00 Hill Farmers (Life Membership) | 1654522922130 * 1

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Hill Farmers (Life Membership) x 1

Hill Farmers (Life Membership) ₹5,000

Organizational Membership ₹2,500

Yearly Members ₹100.00

Amount Due settings

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Name:	ANKIT BHANDARI
Gender :	Male
Fathers Name :	KSB
Phone/Whtsaap:	7895648099
Email:	ankit07bhandari@gmail.com
Address from Hills :	near masseeh dilasa school , village tiloth ,
Current Address:	near masseeh dilasa school , village tiloth ,
Membership Type
Hill Farmers (Life Membership):	1
Amount Due:	₹5,000

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