National Human Rights Defenders of India

APPLICATION FORM FOR MEMBERSHIP

Name [Block Letters]

S/o-D/o-W/o

Gender

Contact No. 1

Contact No. 2

Postal Address

Post Office

Pin Code

Police Station

Signature

Photo

District

State

Present Address

Date of Birth

Age

Educational Qualification

Profession

Member Type

Profession if others

Introduced by

ID No. of Introducer

Submit any one documents from following

Aadhar Card

Passport

Driving License

Voter Card

Mandatory Documents For Non Govt. Employee

Character Certificate

DeclarationI have read all the rules and regulation of the NHRCI. I declare that the above information is true and correct to my knowledge and belief and I fully understand that my application will Stan cancelled if any information by me is found to be false or twisted. After deposit membership amount is not refundable