Indian Adventure Foundation National Headquarter Moradabad

SPECIAL MEMBERS FORM

PLEASE FILL IN CAPITAL LETTERS NOTE :- INCOMPLETE FORM WILL BE NOT ACCEPTED

Membership Type

SPECIAL MEMBERSHIP@1150/-

State*

City*

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Name*

Father Name*

Mother Name*

Date of Birth*

Blood Group*

Gender*

Occupation*

Member Category*

Aadhar Number/ Country Id Proof Number/Others*

Aadhar Photo/passport photo/Other *

Pancard Number/passport Number/Other*

Pancard Photo/passport photo/Other*

Permanent Address 1*

Permanent Address 2*

Pincode*

Mobile Number*

WhatsApp Number*

Designation*

Email*

Signature*

Reference Type*

Reference Name*

IAF Club No

Declaration: I hereby declare that I have not been expelled at Unit/State and National level of the organization. The above given information is true and valid. However, if any defect found, the organization contains full right to cancel my membership. I have read aims & objectives of the association. I undertake to abide by its rules and regulations.

Paid*

I agree *