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Akhil Bhartiya Veer Gurjar Mahasabha (Reg, No. 298/2012) Village:- Ankhir, Sector 21 D, Faridabad 121003, Cell No:-9210060006, 9899177823, 9720970970, Whatsapp:- 9911542929 Facebook Group: http://www facebook. com/#!/groups/veergurjarmahasabha/ Email:- veergurjarmahasabha2012@gmailcom Website:- www.veergurjarmahasabha.com, WWW.abvgm.com Membership Form G Code... Name: Fathers Name:~ Gotra, Mothers Name: Gotra, Photo Date of Birth: Age: Email Address: Phone No: Parental Village Address:- Permanent Address: District Sta Vidhan Sabha: Lok Sabha Education/ Qualification: Occupation:- (Service Govt Or Private /Business/Student/Other}. Blood Group : (Medical Blood Group Report Must Be Attached With The Form) Photo Copy Of ID Proof Must Be Attached With The Form. Only These ID Proofs { Driving Licence, Voter Card, Ration Card, Passport, Aadhar Card) Will Be Accepted, . Ll S/o Sh declare that information given by me in the form is true. have never been convicted of any criminal offences by any court. | will give my full efforts for the upliftment of Gurjar Community. 4. Sign of Card Holder... bate. Pac 2. Sign Of Card Issuing Officer (District) Names Mobile No:- +91- 3.Sign Of Card Issuing Officer (State) ve Name Mobile No:- +91- 4, Sign OF Card Issuing Officer (Center)... Name... sone Mobile No:- +91 Membership Fees:- Rs 150 (Lifetime)

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