MEMBERSHIP FORM

Join the Pravasi Malpura Family • All fields marked with * are mandatory

PERSONAL DETAILS

Full Name *

Father's Name *

Date of Birth *

Gender *

Photo Upload * (Passport-size)

Blood Group (optional)

CONTACT INFORMATION

Mobile Number *

Alternate Mobile Number

WhatsApp Number *

Email ID *

Current City *

Emergency Contact Person & Number *

Complete Address *

FAMILY DETAILS

Family Members & Relation *

Number of Adults *

Number of Children *

Native Village / Mohalla in Malpura *

Permanent Address in Malpura *

PROFESSIONAL / BUSINESS DETAILS

Profession / Occupation *

Business / Workplace Name *

Department / Organization *

Designation *

Work Experience (Years) *

Business Type / Category *

Official Address *

Website / Business Link

Skills / Services You Offer *

Areas in Which You Can Help Others *

DIRECTORY INFORMATION (Public Display)

Members will see this on the directory page

I agree to display my information in the public member directory

MEMBERSHIP CATEGORY (Select One) *

General Membership

3,100

Silver Membership

11,000

Gold Membership

21,000

Platinum Membership

51,000

PAYMENT DETAILS

Payment Method *

Transaction ID *

Date of Payment *

Payment Screenshot Upload *

ADDITIONAL INFORMATION

Your Expectations from Pravasi Malpura Club

Areas you wish to volunteer in

Suggestions / Feedback

AGREEMENTS

I confirm that all information provided by me is accurate.I agree to abide by the rules and guidelines of the Pravasi Malpura Club.I allow the club to use my information for community support and networking.I agree to the privacy policy and directory display terms.

Become a Member • Join the Pravasi Family