Mahamilan Seva Trust

(SOCIAL WELFARE ORGANISATION)

Regd. under India Govt. Trust Act.

Basantapur (Amtala More), Arambagh, Hooghly, Word No. 17

Member Type

General Member Rs.1,600

Executive Member Rs.5,000

Corporate Member Rs.1 lakh

Lifetime Member Rs.10 lakh

Name of the Applicant

Father's Name / Husband's Name

Date of Birth(DD/MM/YYYY)

Age

Gender

Male

Female

Mobile Number

Vill / Town

P.O

Block

Police Station

District

Pincode

Occupation

Referred by P.R.O

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I hereby declare that all the above information provided by me is true and correct to the best of my knowledge.