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Associate Form

Application Form of Membership/Registration

To
The Secretary,
Daughters of Charity (India),
619,Palivalandco, Patiala House, New Delhi -110001

Required Accommodation /Scholarship/ Admission / Placement National or International / Canteen / Loan / Aid / Legal Help / Medical Help / others :

If Required Accommodation how many rooms

Location

DD/Transaction No.

Registration payment online

Name of Associate:

Amount:

*Only numeric allowed.

Sir, I am interested in social work and want to join your organization. Therefore kindly enroll me, my bio- data & declaration are given below:-

Name:

Father's/Mother's/Spouse Name

Date of birth:

Address (Residence):

Address (Office):

Contact No:

E-Mail:

Password

Password length must be between 4 to 10 characters

Confirm Password

Passwords do not match.

Passport/Identity card No:

Gender:

Qualification:

Profession:

Family Income(Annual for all resorces*):

* Only numeric allowed.

Native place:

Place of social work:

It is declared that all contents of my above bio- data/form are true and correct and nothing has been concealed in it, I have never been involved in any criminal activity(of any type).I have always followed all rules & regulations, rights & duties towards the (above mentioned) organization.I am agreed to pay non-refundable membership/registration fee and other charges ,I further declare that I will obey all orders and instructions issued by my appointing/enrolling authority. In case of my misconduct / misdeed or misappropriation the appointing/enrolling authority have right to take any action against me.

Dated:

Place:

Applicant:

Sign:

I Agree to the Terms & Conditions

Required Checked Agree or not

Associate Form

Application Form of Membership/Registration

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