Initiative Membership Form
The initiative is a group of professional aimed to promote social equity and justice based on the democratic values.
Name *
Your answer
Address *
Your answer
Age *
Your answer
Last Qualification *
Subject *
Currently Working - Name of Organization
Your answer
Current Organization- Designation
Your answer
Current Organization - Work Station (Block & District)
Your answer
What kind of support you are looking for? *
Your interest *
eg. Health, Nutrition, Livelihood, Homeless, Education, Rural Development etc
Contact Number *
Your answer
Email Id *
Your answer
Submit
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