Membership Form

Membership Form - NGOSamachar

Your Subscription will be for 1 (one) year of term from the date we receives payment in our account.

• Name of Organisation *
• Contact Person *
• Designation of Contact Person
• Email Address of Organisation *
• Postal Address *
  Street Address
  Address Line 2
  City
  State / Province / Region
  Postal / Zip Code
  Country
   
• Telephone No *
• Fax No. *
• Website of Organisation

• All the payments (cheque/dd) should be made in favor of "U. M. Naidu"
  Amount: 3,000.00 Rs.

• DD / Cheque No.
• DD / Cheque Date
• DD / Cheque from Bank

• 	Type the two words: