Membership Application Form

1. Personal Details

Candidate Name *

Father's Name *

Mother's Name *

Date of Birth *

Blood Group

Gender *

Category *

Nationality *

Recent Passport Photo *

Upload Photo

Max 5MB (JPG, PNG, WebP)

Permanent Address *

Contact No *

Alternative Contact No

Email ID *

Create Portal Password *

Password Security Requirements:

12+ Characters Uppercase (A-Z) Lowercase (a-z) Number (0-9) Special Symbol (!@#$)

This password will be used to log into your Member Dashboard.

2. Location & Geographic Details Enter PIN Code for 1-Click Auto-Fill

Pin Code *

1-Click Auto-Fill: 6-digit PIN code enter karte hi State, District, Sub-division, aur Block automatically select ho jayenge.

State *

District *

Sub-division / Tehsil

Block (Rural)

Grampanchayat (GP)

Municipality (Urban)

Ward Number

3. Education Qualification

Examination	Stream / Subject	Board / University	Passing Year	% Marks / Grade
10th / Secondary
12th / Sr. Secondary
Graduation (BA/BSc/BCom/BTech)
Post Graduation / Others

4. Employment Status & Experience

Select Employment Status *

Work Experience

Project Work Experience (If Any)

5. KYC Details & Document Uploads

Identity Proof Type *

Identity Proof Document Number *

ID Front-Side Upload *

Front side of Aadhaar / Voter / DL

ID Back-Side Upload *

Back side with address

Communication Address Proof Type (Optional)

Address Proof Number (Optional)

Address Proof Front-Side (Optional)

Address Proof Back-Side (Optional)

Applicant Signature Upload *

Sign on blank white paper & upload photo

Signature Preview

6. Referral Programme

Referral Code (Optional)

If you were referred by an active Coordinator or Member, enter their ID here.

7. Bank Details

Bank Name *

Bank Account Number *

IFSC Code *

UPI ID (If available)

8. Membership Plan & Payment Options

Select Preferred Membership Plan *

Select your preferred membership tier to view applicable registration fee.

Applicable Registration Fee: ₹1,716.00

Standard (Yearly)

Payment Mode: Direct Bank Transfer / QR Code (Offline Verification)

Option 1: 1-Click Pay with UPI App / QR

Instant & 0% Convenience Fee

Scan Official UPI QR Code to Pay

Option 2: Direct Bank Transfer (NEFT / RTGS / IMPS)

Bank Name:	HDFC Bank
Account Number:	50200115635690
IFSC Code:	HDFC0009850
Account Name:	Mahatejas Trust

Easy Verification: Enter your 12-digit UPI Reference (UTR) OR upload your Payment Screenshot (any one is sufficient).

12-Digit Reference / UTR Number Option A 0 / 12 Digits

Found in UPI app / bank SMS. If entered, screenshot upload is optional.

Upload Payment Slip / Screenshot Option B

Attach transaction screenshot (JPG, PNG, WebP max 5MB).

Mandatory Applicant Declarations: I confirm that the information provided by me is true and correct. I agree to the Terms and Conditions, Privacy Policy, and applicable membership rules and regulations.

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