All India Council Of Human Rights, Liberties & Social Justice

REGISTERED SOCIETY UNDER NCT GOVT NEW DELHI, UNDER THE SOCIETY REGISTRATION ACT (XXI) 0F 1860 GOVT OF INDIA
REGISTERED WITH PLANNING COMMISSION OF INDIA VIDE UNIQUE ID : DL/2011/0045728 UNDER PARTNERSHIP SYSTEMS

APPLICATION FORM
FOR NEW MEMBERSHIP
(Common Application)
SUBMIT THE COMPLETE FORM WITH THE FOLLOWING DOCUMENTS AND SEND TO US ON THE BELOW ADDRESS FOR SELECTION

SELECTION PROCESS TIME 7/10 DAYS

NOTE: KINDLY SEND THE FOLLOWING DOCUMENTS ALONG WITH THE APPLICATION
1. 4 NOS. PASSPORT SIZE PHOTO
2. ADDRESS PROOF & PHOTO ID PROOF
3. DD/CHEQUE FOR YOUR DOCUMENT PREPARATION
4. IF ADVOCATE : BAR COUNCIL ID CARD
5. RC COPY FOR CAR STICKER
6. Self Address Envelope with complete address with pin code

CONTACT / POSTAL ADDRESS

CENTRAL OFFICE: H-10, BASEMENT, NDSE PART ONE NEW DELHI 110 049
Phone: 011 41349791, 9873087903
visit: www.humanrightscouncil.in , news : www.newsindiatoday.com ,
Email: humanrightscouncil.org@gmail.com

All India Council Of Human Rights, Liberties & Social Justice

REGISTERED SOCIETY UNDER NCT GOVT NEW DELHI, UNDER THE SOCIETY REGISTRATION ACT (XXI) 0F 1860 GOVT OF INDIA
REGISTERED WITH PLANNING COMMISSION OF INDIA VIDE UNIQUE ID : DL/2011/0045728 UNDER PARTNERSHIP SYSTEMS

To,
CHAIRMAN
CENTRAL SELECTION COMMITTEE
MEMBERSHIP FORM
PASTE YOUR PASSPORT
PHOTOGRAPH WITH
FRONT FACE AND SELF
SIGNATURE AT THE
BACK SIDE

(Fill the form with Capital Letter only)

Member Name

: ________________

Fathers Name

: ________________

Date Of Birth

: ________________

Mobile

:________________

Landline :________________

Email ID ( Capital Letter Only) : ________________

Residence Address Permanent

: _________________________________________

Residence Address Present

: _________________________________________

Qualification

: _________________________________________

I am declaring that I am joining the organization with my own acceptance and consent and not been
forced by anyone and want to help the organization to serve the society with dignity, will not do any
illegal activity which against the Indian law and society
Please provide three references ( One from Govt. Sector) :
1. Name_________________Mobile__________Relationship____________email ID______________
2. Name_________________Mobile__________Relationship____________email ID______________
3. Name________________ Mobile__________Relationship____________email ID______________
Signature Member

_________________ Date ___________________

Official Use Only

The National Selection Committee has examined your all details and hereby Approve / Disapprove your
Application for the membership.
Membership No.

: ___________________________

Designation granted

: ___________________________

Signature

Signature

Chairman Selection Committee

National President

All India Council Of Human Rights, Liberties & Social Justice

REGISTERED SOCIETY UNDER NCT GOVT NEW DELHI, UNDER THE SOCIETY REGISTRATION ACT (XXI) 0F 1860 GOVT OF INDIA
REGISTERED WITH PLANNING COMMISSION OF INDIA VIDE UNIQUE ID : DL/2011/0045728 UNDER PARTNERSHIP SYSTEMS

MUST ANSWER THESE QUESTION

Common form for AICHLS/NCNB

What is your objective to join this organization?

: _________________________________

How do you want to serve the society?

: _________________________________

How you came to know about us ?

: _________________________________

Are you joining with your own consent? : Yes / No

: _________________________________

Have you ever been pressurised by any existing member or

anybody to become part of our AICHLS/NCNB: Yes / No

: _________________________________

Have you ever been convicted by any court in India : Yes / No.

: _________________________________

Have you ever involved with any illegal activity which is against
the Indian Law/Constitution: Yes / No.

: _________________________________

Have you ever been involved with any human rights

activity: Yes / No

: _________________________________

Are you ready to serve the society voluntarily / without

Any remuneration / Commission / Salary etc.? : Yes/ No

: _________________________________

At what level are you ready to take responsibility & How many
membership can you generate from your social
network? :

: _________________________________

Are you ready to make your working /action committee: Yes/ No

within how many days?

: _________________________________

Are you suffering with any kind of disease: Yes/ No

: _________________________________

Are you ready to submit your written report every month: Yes/ No

: _________________________________

Signature (member only)

NOTE: KINDLY SEND THE FOLLOWING DOCUMENTS ALONG WITH THE APPLICATION
1.

4 NOS. PASSPORT SIZE PHOTO

2.

ADDRESS PROOF & PHOTO ID PROOF

3.

DD/CHEQUE FOR YOUR DOCUMENT PREPRATION

4.

IF ADVOCATE : BAR COUNCIL ID CARD

5.

RC COPY FOR THE CAR STICKER

6. Self Address Envelope with complete address with pin code

7.

National Council of News and Broadcasting

REGISTERED SOCIETY UNDER NCT GOVT NEW DELHI, UNDER THE SOCIETY REGISTRATION ACT (XXI) 0F 1860 GOVT OF INDIA
REGISTERED WITH PLANNING COMMISSION OF INDIA VIDE UNIQUE ID : DL/2011/0045728 UNDER PARTNERSHIP SYSTEMS

To,
CHAIRMAN /EDITOR IN CHIEF
CENTRAL SELECTION COMMITTEE
MEMBERSHIP FORM

PASTE YOUR PASSPORT

PHOTOGRAPH WITH
FRONT FACE AND SELF
SIGNATURE AT THE BACK
SIDE

(Fill the form with Capital Letter only)

Member Name

: ________________

Fathers Name

: ________________

Date Of Birth

: ________________

Mobile

:________________

Landline :________________

Email ID ( Capital Letter Only) : ________________

Residence Address Permanent

: _________________________________________

Residence Address Present

: _________________________________________

Qualification

: _________________________________________

I am declaring that I am joining the organization with my own acceptance and consent and not
been forced by anyone and want to help the organization to serve the society with dignity, will
not do any illegal activity which against the Indian law and society
Please provide three references ( One from Govt. Sector) :
1. Name_________________Mobile__________Relationship____________email ID______________
2. Name_________________Mobile__________Relationship____________email ID______________
3. Name________________ Mobile__________Relationship____________email ID______________

Signature Member

_________________ Date ___________________

Official Use Only

The National Selection Committee has examined your all details and hereby Approve /
Disapprove your Application for the membership.
Membership No.

: ___________________________

Designation granted

: ___________________________

Signature

Signature

Chairman Selection Committee

National President

National Legal Council

(A LEGAL UNIT OF ALL INDIA COUNCIL OF HUMAN RIGHTS, LIBERTIES & SOCIAL JUSTICE)
REGISTERED SOCIETY UNDER NCT GOVT NEW DELHI, UNDER THE SOCIETY REGISTRATION ACT (XXI) 0F 1860 GOVT OF INDIA
REGISTERED WITH PLANNING COMMISSION OF INDIA VIDE UNIQUE ID : DL/2011/0045728 UNDER PARTNERSHIP SYSTEMS

To,
CHAIRMAN
CENTRAL SELECTION COMMITTEE
MEMBERSHIP FORM
(Fill the form with Capital Letter only)
Member Name

: ________________

Fathers Name

: ________________

Date Of Birth

: ________________

Mobile

:________________

PASTE YOUR PASSPORT

PHOTOGRAPH WITH
FRONT FACE AND SELF
SIGNATURE AT THE BACK
SIDE

Landline :________________

Email ID ( Capital Letter Only) : ________________

Residence Address Permanent

: _________________________________________

Residence Address Present

: _________________________________________

Qualification

: _________________________________________

I am declaring that I am joining the organization with my own acceptance and consent and not been
forced by anyone and want to help the organization to serve the society with dignity, will not do any
illegal activity which against the Indian law and society
Please provide three references ( One from Govt. Sector) :
1. Name_________________Mobile__________Relationship____________email ID______________
2. Name_________________Mobile__________Relationship____________email ID______________
3. Name________________ Mobile__________Relationship____________email ID______________

Signature Member

_________________ Date ___________________

Official Use Only

The National Selection Committee has examined your all details and hereby Approve / Disapprove your
Application for the membership.
Membership No.

: ___________________________

Designation granted

: ___________________________

Signature

Signature

Chairman Selection Committee

National President

All India Council Of Human Rights, Liberties & Social Justice

REGISTERED SOCIETY UNDER NCT GOVT NEW DELHI, UNDER THE SOCIETY REGISTRATION ACT (XXI) 0F 1860 GOVT OF INDIA
REGISTERED WITH PLANNING COMMISSION OF INDIA VIDE UNIQUE ID : DL/2011/0045728 UNDER PARTNERSHIP SYSTEMS

OATHS/ACCEPTANCE/DECLARATION (ONLY MEMBER)

Common form for AICHLS/NCNB/NLC

TO, CHAIRMAN
CENTRAL SELECTION COMMITTEE
Dear Sir,
I_______________________S/o_________________

Residence of______________________________________

Solemnly take oaths/accepted and declared that

I am joining and subscribing AICHLS/NCNB/NLC with my own consent without any force or pressure from anybody from AICHLS/NCNB/NLC
or from outsider

I will serve the AICHLS/NCNB/NLC , People & Society absolutely on the basis as volunteers for which I will not claim any kind of payments
or service charges or any kind of expenses.
I will be fully dedicated to Human rights, Liberties and social Justice for masses and not for individual or my benefits

I will not misuse the name of AICHLS/NCNB/NLC for my own sake and benefits Strictly, if found liable to face action by CENTRAL
DISCIPLINE ACTION COMMITTEE OR NATIONAL PRESIDENT, which is final.
I will Pay all my Membership fee , joining fee , Contribution, subscription in time and with my own acceptance , consent and agreement,
I will obey the code of conduct of the AICHLS/NCNB/NLC in all mode and all time
I will not be involved with any kind of illegal activities , functions, seminars , rally which against the law of India and Constitution ,society

That AICHLS/NCNB/NLC will not be held responsible at all for my involvement with any kind of illegal activities , business , court cases
which is against the law of India , Constitution and society

I have never been involved /indulged with any kind of human rights violation and never been convicted by the court for the
same. My membership can be withdrawn immediately, if found guilty with anything violated the law of India Constitution or society or the
code of conduct of the society and accepted the final decision of the CENTRAL DISCIPLINE ACTION COMMITTEE OR NATIONAL
PRESIDENT.

I also authorize AICHLS/NCNB/NLC to put my name on the website i.e. www.humanrightscouncil.in

I will attend all meetings of the AICHLS/NCNB/NLC time to time in my respective jurisdiction
I will the serve the AICHLS/NCNB/NLC with whatever responsibility and accountability given to me
I understand that my Membership is non-transferable and once the payment is made, it is non-refundable.

Any kind of misbehaviour or misconduct may result in rejection of membership of AICHLS/NCNB/NLC. All disputes subject to jurisdiction of
Delhi only.

That AICHLS/NCNB/NLC will not be responsible for any misuse of Identity Card , press card , legal council card issued to me during the
course of my Membership with AICHLS/NCNB/NLC , National Council of News and Broadcasting , National Legal Council.

That On expiry of validity, I will submit my Identity Cards to the National Administration Office. After expiry, I will renew regular
membership within 30 days. In case of change of address, I will inform the same to the National Administration Office .

That in case of loss of the identity Card, I will inform the National Administration Office in writing along with the F.I.R. immediately.

That I am ready to face Strict action , if found guilty floating the rules and regulations of AICHLS/NCNB/NLC, and are also punishable under
the Press & Societies Act.

That If I am holding the press ID card , I will report all the incidents immediately to the NCNB and voluntarily

That being a active member of AICHLS/NCNB/NLC will contact my respective Area Units / State Units / National Administration Office once
in a month.

That If I am holding the Legal ID card , I will serve the people absolutely free and voluntarily and provide free legal advise time to time.
If I have any doubt, question or problem, will contact AICHLS/NCNB/NLC National Administration Office with the All rights reserved to
AICHLS/NCNB/NLC.
DECLARATION: I hereby solemnly affirm and declare that The particulars mentioned by me here in above are true & correct to the
best of my knowledge and belief and nothing has been concealed or suppressed thereof. If anything found incorrect at any stage, my
membership may be terminated. 2. I honestly declare that I will not involve myself directly or indirectly in any act which will be against the
prestige of our Nation, Society, Journalism and AICHLS/NCNB/NLC as well. 3. I will abide by the rules and regulations and Byelaws of the
AICHLS/NCNB/NLC in force from time to time.
Signature (Member only)
Name________________ Date_________________ Location_______________Mobile ___________________________
Signature (Reference only)
Name________________ Date_________________ Location_______________Mobile ___________________________

All India Council Of Human Rights, Liberties & Social Justice

REGISTERED SOCIETY UNDER NCT GOVT NEW DELHI, UNDER THE SOCIETY REGISTRATION ACT (XXI) 0F 1860 GOVT OF INDIA
REGISTERED WITH PLANNING COMMISSION OF INDIA VIDE UNIQUE ID : DL/2011/0045728 UNDER PARTNERSHIP SYSTEMS

PERSONAL DETAIL FOR MAKING ID CARD

Common form for AICHLS/NCNB/NLC
KINDLY FILL THE DETAILS WITH CAPITAL LETTER, WE WILL NOT RESPONSIBLE FOR ANY SPELLING MISTAKE THEIR AFTER
I am giving my particulars to make my Identity Card / Certificate / Car Sticker etc. as details are given below , I am fully responsible for any spelling
mistake if found in this slip and I have submitted my full documents charges ( Voucher Details attached)
ONLY CAPITAL LETTER TO BE FILLED
Member Name

: _________________________________________________________________

Fathers Name

: _________________________________________________________________

Spouse Name

: _________________________________________________________________

Date Of Birth

: _________________________________________________________________

Mobile

: _________________________________________________________________

Landline

: _________________________________________________________________

Email ID (Capital Letter Only) : _________________________________________________________________

Blood Group

: _________________________________________________________________

Emergency Contact No :

: _________________________________________________________________

Complete Residence Address Permanent with pin code

___________________________________________________________________________________________________________________

Complete Residence Address Present with pin code

____________________________________________________________________________________________________________________

Write your Complete Address with pin code

((For Delivery The Documents))

____________________________________________________________________________________________________________________
Signature (member only)

Official Use Only

The National Selection Committee has examined your all details and hereby Approve / Disapprove your Application
for the membership.
Membership No.

: ___________________________

Designation granted

: ___________________________

Signature (Chairman Central Selection Committee)

All India Council Of Human Rights, Liberties & Social Justice

REGISTERED SOCIETY UNDER NCT GOVT NEW DELHI, UNDER THE SOCIETY REGISTRATION ACT (XXI) 0F 1860 GOVT OF INDIA
REGISTERED WITH PLANNING COMMISSION OF INDIA VIDE UNIQUE ID : DL/2011/0045728 UNDER PARTNERSHIP SYSTEMS

Expense Slip
(Treasury dept)
Documents Charges
TO: CHAIRMAN
CENTRAL TREASURY COMMITTEE
Dear Sir
I AM SUBMITTING MY DOCUMENTARY CHARGES TO PREPARE MY DOCUMENTS AS PER THE DETAILS

NAME_______________

S/O MR._____________

Particulars

Amounts

DOCUMENTS CHARGES FOR ALL INDIA COUNCIL OF

HUMAN RIGHTS, LIBERTIES & SOCIAL JUSTICE
Documents Are Like: National Identity Card, Certificate, Car
Sticker, Postal Charges Etc.
COMPULSORY FOR EVERY MEMBER
DOCUMENTS CHARGES FOR PRESS CARD issued by the
National Council of News & Broadcasting
Documents Are Like: All India PRESS Card, Certificate, Car
Sticker, Postal Charges Etc.
COMPULSORY FOR EVERY MEMBER
DOCUMENTS CHARGES FOR NATIONAL LEGAL COUNCIL
Documents Are Like: Legal Card, Certificate, Car Sticker, Postal
Charges Etc.
COMPULSORY FOR EVERY MEMBER

Rs. 975/Each

MOBILE_____________
DD/Cheque
No. /
Dated

Drawn
Bank
Name

Location

Rs.975/+
Rs. 2000/Each

Rs. 975/Each

CONTRIBUTION
SPECIAL DONATION
Subscription For Office Bearer As Per Memorandum and
designation and level in the AICHLS/NCNB/NLC

KINDLY SPEAK TO US FOR PRESS CARD AT 987300 5424

All Contribution /Donations/Fees Etc. To Be By DD/PAY ORDER In The Favour of ALL INDIA
COUNCIL OF HUMAN RIGHTS,LIBERTIES & SOCIAL JUSTICE payable New Delhi

Indian Bank:

Saving A/c No. : 6106 880946 payable New Delhi

Online Transfer: Please email us the transit number of online transfer
Branch Address: South Extension -I, New Delhi
CBS Code: 00361 - IFS Code: IDIB000 S032
After Depositing Money Please mail us humanrightscouncil.org@gmail.com