Membership Application

D.P.O.M.L.S

Durgapur People of My Life Society

Regd - S0007208/2019-2020

WITH YOU, IN EVERY SITUATION

NGO REGISTRATION DETAILS

NGO Darpan ID	: WB/2021/0279163
Registration No.	: S0007208/2019-2020
PAN	: AAFAD5456K
12A Certificate No.	: AAFAD5456KF/224101
80G Certificate No.	: AAFAD5456KF/2024101
TAN	: CALD19681E

सेवा • संवेदना • समर्पण

MEMBERSHIP APPLICATION FORM

Fill in all required fields carefully. Fields marked * are mandatory.

1. PERSONAL INFORMATION

Full Name

Date of Birth

Gender

Blood Group

Passport Size Photo

Click to upload
JPG / PNG, max 2MB

Father's / Spouse Name

Occupation

Organization / Company Name

5. REFERENCE & IDENTIFICATION

Reference by Existing Member

Aadhaar No. (Optional)

Voter ID / PAN / Other ID

Identification Mark

6. DECLARATION

I hereby declare that the information provided above is true and correct to the best of my knowledge. I agree to abide by the rules, regulations and objectives of Durgapur People of My Life Society (D.P.O.M.L.S.)

Date

Place

Applicant Signature

(Sign on printed form)

After submission, your application will be reviewed by the NGO office. You will receive your Membership ID upon approval.