Regular Member - Shri Jagannath Mandir

Regular Members Registration

SHRI JAGANNATH MANDIR, TYAGRAJ NAGAR, DELHI

Application Form No

Your Name

Father's / Husband's Name

Marital Status

Mobile - Number

Residence Tel No

Your Email

Date of Birth

Designation / Post if working

Present Address

Official / Business AddressOfficial / Business Address

PAN Card/Aadhar Card/Driving License and ID proof recoognised by Govt. of India

Give name of two persons for reference

Name

Mobile Number

Address

Terms and Conditions

Declarations

I, Name , declare that, I have read all the above mentioned terms & conditions and I hereby undertake to abide by the same Rules and Regulations of the Mandir - Society. I further request that my membership may be kindly accepted and I may be given an oppertunity to serve at the Feet of Lord Jagannath as a Regular Members

Regular Members Registration

SHRI JAGANNATH MANDIR, TYAGRAJ NAGAR, DELHI

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