*Edition Hindi
*Membership Amount
1 year, 2 year, 5 year or Lifetime
 
*Name  
*Father_Name  
*Previous_Membership_(if_any) _
*Present_Address______________  
*Village _ *Post
*Tehsil *District  
*State   *Pin_Code  
*Via   *Phone_No_  
*Draft/Receipt_No.   *Date  
*Rupees   *Bank