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COORDINATOR’s REGISTRATION FORM
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FULL NAME
*
First
Last
Phone
*
Email
*
AADHAR CARD FRONT
*
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AADHAR CARD BACK
*
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PAN CARD
*
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BANK PASSBOOK
*
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COORDINATOR ONE TIME CONTRIBUTION FEES
*
A) 1000/- ONLINE PAYMENT (NETBANKING, UPI, BANK TRANSFER)
B) WITH FIRST 20 APPLICATION FEES
UTR NUMBER
*
TYPE- “000” IN CASE YOU CHOOSE OPTION (B)
PAYMENT SCREENSHOT
*
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WRITE “PAYING WITH FIRST 20 APPLICATION FEES” ON A PAPER/ SIGN AND UPLOAD
Date / Time
*
Date
Time
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