Sir, 

I want to be a Trustee or Member of Agroha Vikas Trust. 

I agree to deposit  Rs.for Construction Programs/Corpus of the trust through 

Cheque or Draft No. , Dated. 

(Cheque/Draft in Favour of Agroha Vikas Trust payable at New Delhi, India) 

Please allow me to be a Trustee/Member of trust. 

Personal Description: 

First Name         Last Name  

Father's or Husband's Name        Gotra   Aren Bansal Bhandal Bindal Dharan Garg Goel Goen Jindal Kansal Kuchhal Mangal Mittal Mridukul Nagal Singhal Tayal Tingal   

Postal Address 

City  StatePin/Zip  Country  

E-mail Address  

Occupation  Business Enterpreneur Professional Service Self Employed Social Worker  

Office Address  

City  State Pin/Zip   Country  

Telephone :  Res      Office