॥ Become a Member ॥

Membership Application

Fill in the form below to join the organisation. Fields marked * are required.

1Personal details

Full name

As you want it printed on your ID card

Father’s / Husband’s name

2Contact details

Mobile number

+91

E-mail

Your ID card will be sent to this e-mail address.

Aadhaar number

Your Aadhaar number is only used to check your membership. It is never printed on the ID card or shown on the website.

3Address and area

District

Tehsil

Panchayat Samiti (optional)

Gram Panchayat (optional)

Village (optional)

Ward number

Councillors in urban areas can leave Panchayat Samiti, Gram Panchayat and Village empty.

PIN code

State

4Photo

Add your photo

A passport-size photo with your face clearly visible. You can take one with your phone now.

Choose photo

5DeclarationI declare that all the information above is correct, and I will follow the rules of the organisation.

Your details are used only for membership and are never shared with anyone else.

Your application has been submitted!