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NARAYANPUR
YOUTH CLUB
VILL - NARAYANPUR, P.O - AMIYA NARAYANPUR,
P.S - THANARPARA, DIST - NADIA, PIN - 741165
“Youth power for society,
for humanity, for the nation”
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Member Registration Form
Fill all details correctly. Fields marked * are required.
Membership
Membership category
*
— Select —
General Member — ₹100.00
Annual Member — ₹200.00
Life Member — ₹2,500.00
Student Member — ₹50.00
Honorary Member — Free
Associate Member — ₹150.00
Volunteer — Free
I also want to volunteer
Personal details
Full name
*
Father’s / Guardian’s name
Date of birth
*
Gender
— Select —
Male
Female
Other
Blood group
— Select —
A+
A-
B+
B-
O+
O-
AB+
AB-
Occupation
Education
Contact details
Mobile number
*
WhatsApp number
Email
Full address
*
Passport size photo
*
JPG / PNG / WEBP · max 300 KB — passport-size photo on a plain background; big photos are shrunk automatically
Verification
ID proof type
— Select —
Aadhaar
Voter ID
PAN
School/College ID
Other
Aadhaar card — front side
*
Picture (JPG/PNG)
PDF
JPG / PNG / PDF · max 500 KB — kept private, only authorised officials can see it. A masked Aadhaar (only last 4 digits visible) is safest
Aadhaar card — back side
*
Picture (JPG/PNG)
PDF
JPG / PNG / PDF · max 500 KB — kept private, only authorised officials can see it. A masked Aadhaar (only last 4 digits visible) is safest
Last 4 characters of ID
For privacy we never store the full number
Why do you want to join?
Skills / interests
e.g. football, singing, photography, computers
Fee payment
Payment mode
— Select —
UPI
Cash at club
Bank transfer
Payment reference / UTR
If paid by UPI/bank, enter the 12-digit UTR
Create a login password
Password
*
Password: at least 8 characters with letters and numbers
Confirm password
*
Consent
I confirm the information is true and allow the club to store and use it to manage my membership. Details:
Privacy Policy
I consent to my photo appearing in club publications
My name and member number may appear in the member directory
Security check: solve the sum
*
2
+
2
=
?
Wrong answer to the security question — please answer the new one
Submit application
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