Sukanya Surakshya Charitable Trust

Panchayat-Level Member — Application Form

Regd No: OD55930394445581Y | +91-8114883967 | info@sukanyasurakshya.org

www.sukanyasurakshya.org

Passport
Photo
(Paste Here)
Personal Details
Full Address
Bank Details
Documents Attached
☐ Passport-size photographs
☐ Aadhar Card photocopy
☐ Bank Passbook photocopy
☐ PAN Card photocopy
Declaration: I hereby declare that all the information provided in this form is true and correct to the best of my knowledge. I understand that providing false information may result in the rejection of my application.
Applicant's Signature
Date
Father/Mother's Signature
Sukanya Surakshya Charitable Trust | Regd: OD55930394445581Y | www.sukanyasurakshya.org