Membership Form

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Membership Form

Apply for membership

Name *

Father's Name *

Gender *

Male

Female

Other:

Marital Status *

Single

Married

Other:

Date Of Birth *

YYYY

Education *

Profession *

Blood Group *

Address *

Mobile Number *

Email-Id *

Identity Proof *

Voter Id

Aadhar Card

Pan Card

Required

Membership Options *

One year Subscription(Rs.100)

Life Time Subscription(Rs.5000)

Terms & Conditions

(1). I never be involved in any illegal/unlawful activities inside the countries or elsewhere.
(2). PLJB has right to cancel|modify|update my membership anytime anywhere, if found guilty or irregularities.
(3). I am bound to follow PLJB norm till my membership.

Where are you From? *

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