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REGISTRATION FORM
Name :
Address :
Phone : Res Office :
E-Mail ID :  
Occupation :  
Martial Status : Married     Unmarried  
Date of Marriage :  
 
DETAILS OF THE FAMILY MEMBERS
S.No. Name D.O.B Age Occupation
1.
2.
3.
4.
5.
PLEASE USE THIS GIFT FOR
Living Bread for Destitutes Divine Home for the Orphan children
Education of poor children Medical Aid to the poor
Love feast camps               Any other
DECLARATION
We Mrs. & Mr & Family are a part of the Divine Charitable Trust Family and we would like to help and serve the poorest of the poor. We will contribute Rs
Monthly Quarterly Halfyearly Annually
Contribution can be given in the form of cheque / DD / Cash infavour of Divine Charitable Trust
   
 
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