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Membership Form
       
  
  Voluntary Contribution (Minimum Rs.500/-*)INR
 

First Name *

Last Name *

Mobile No. *

Email ID *

Date Of Brith

Gender

Address

Pincode

ID Proof

Vidhan Sabha

State

Membership:-

    I want to apply for ABJP Membership (Rs. 5/-*)INR

Subscription:-

 

     Please enrol me for 5 Years ABJP Membership (Rs. 1000/-, Rs.5000/-& Above*)INR Total

Total Amount Rs.

 

 

Declaration Contribution:-

I do hereby that, the contribution from my personal fund and voluntary by nature.

PLEDGE

I am not a member of any other Political Party.

I undertake to abide by the Constitution, Rules and Discipline of the party.

       
* Non Refundable