All Bengal Saskrit Lovers' Association

Membership Form

Name*

Name of Guardian/Husband/Wife*

Postal Address*

Mobile No.*

Email-ID*

Aadhaar No.*

Designation*

Academic Qualification*

Hobby*

Blood Group*

Fresh Membership Renewal (Annual Full Membership ₹100/- ; Life Membership ₹1000/-)

Reference No.*

Payment Screenshot

Payment Amount*

Bank : CANARA BANK Branch : Parcus Road, Burdwan A/C : 110063491712 IFSC : CNRB0019523