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Donor Information (Basic)
Fill below form to share your contact details with YB Foundation team. All this information will be kept confidential and won't be shared with anyone.
* Indicates required question
Email
*
Record my email address with my response
Enter your full name:
(As mentioned in PAN Card)
*
Your answer
Mobile number:
(10 Digit number)
*
Your answer
Whatsapp mobile number:
(10 Digit number)
*
Your answer
Enter Date Of Birth:
*
MM
/
DD
/
YYYY
Employment
*
Choose
Government
Private
Self Employed
Retired
Student
Homemaker
Any Others
Referred by Name (mention NA if not applicable)
*
Choose
Amit Gaikwad
Anand Kadam
Anirudha Rane
Mehul Waskar
Mihir Zemse
Nilesh Gawde
Rohan Bhosle
Rohan Chavan
Sagar Bhalekar
Sahil Kamble
Suraj Ghadshi
Tushar Budke
Viraj Thakur
Yogesh Pate
Non of the above
Enter your Blood Group:
Choose
A +ve
B +ve
AB +ve
O +ve
A -ve
B - ve
AB -ve
O -ve
Do you want to avail Tax Benefit?
*
Choose
Yes
No
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