Jat Samaj Mumbai
 
Membership Form
 

Jat Samaj

Highway House,29 Jawaharlal Nehru Road,
Santacruz(E),Mumbai-400 055.
Email Id :- membership@jatsamajmumbai.com
Ph. No. :-26129968
Web : www.jatsamajmumbai.com


Membership Application Form

Existing Patron and Life member also requested
to fill up this form without any payment and submit,
this information will help us to upgrade database of members .
So we can provide you better services.



  • For "Patron Membership" Fees :Rs. 5100/-
  • For "Life Membership" Fees :Rs. 2100/-
  • For "Ordinary Membership" Fees :Rs.200/- first year,
    there after Rs. 100/-yearly
I
        I hereby declared that,I am jat and my age is above 18 year
Membership Form
*represents compulsory fields(Only For New Member)
New Member Existing Member
*Name *Surname
*Age Gender M          F
*Father's/Husband Name Native Place
*Occupation Designation
Education *Gotras
Your Date Of Birth
dtmn yr
Office Details
Company Name
Address
Tel. No.
Mob. No.
Email Id
Residencial Address
Address
Tel. No.
Mob. No.
Email Id
Bank Details
Compulsory for new member only
I have Paid membership fees By cheque no/Cash
Date
Bank Name
Branch Name
I accept all terms & conditions of Jat Samaj
Introduced By Person(Person should be member of Jat Samaj)
Compulsory for new member only
Name
Mob. No
Jat Samaj Bank Detail,
Bank Of Baroda Santacruz(E),
SB A/C No. :
04130100002642
Name of the Account : JAT SAMAJ

Note : This is at par account so any member can deposite cheque/cash any where in india.
Existing Patron and Life member also requested to fill up this form without any payment and submit,
this information will help us to upgrade database of members .So we can provide you better services.
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