Membership Application

Join the Bengali Association Family

Application Form

Please fill in all the required information carefully

Full Name *

Contact Number *

Email Address *

Age *

Date of Birth *

Blood Group *

Address *

Aadhar Number *

Aadhar Card Image *

Upload JPG, PNG (Max: 2MB)

Membership Type * (Please tick one option)

3 Years Membership ₹ 1,500/- 5 Years Membership ₹ 2,500/- Life Membership ₹ 3,500/-

Declaration: I declare that the above details declared by me are correct to the best of my knowledge.

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