Membership Form - Al Qalam Foundation

Personal Particulars

Title*

Gender*

Full Name*

Age*

Preferred Calling Name*

Educational Qualification*

Subject*

Profession/Post*

Office/Department*

Contact Address

Street Address

Address (Cont.)*

City*

State/Province*

Zip/Postal Code*

Mobile Phone

Home Phone

Email*

Aadhar No.

PAN No.*

Membership Details

Type of Membership*

Membership Fee*

Frequency of Donation*

Mode of Payment

Option to Contact

Appeal to adopt a student

Opt students for help

No of students

Amount

Nature of Donation*

Declaration: I hereby declare that I shall work for the social and educational Upliftment of the Society and the Nation according to the bylaws of Al Qalam Foundation (Trust). *
*Required fields

Instructions

Membership Fee

1.Life Membership Fee: Rs. 1,00,000/-only
2.Special Membership Fee: Rs. 20,000/- p.a.
3.Donor Membership : Any amount
4.General Membership Fee: Rs. 1000/- p.a.

Bank Detail

Account No. : 008888700000169
Bank Name : YES Bank
Branch : Marris Road, Aligarh, UP
MMID : 9532888
IFSC Code : YESB0000088

Fee and other expenses

1.Fee of a poor student: Rs. 6000/- p.a. (Rs. 500/- p.m.)
2.Cost of Books and dress: Rs. 3000/- p.a.
3.Total: Rs. 9000/- per annum, per student

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