"ALL INDIA RAHUL GANDHI BRIGADE CONGRESS" ( JOIN HANDS FOR THE CHANGE )

Instructions

  1. Attach photocopy of approved Address proof, ID proof.
  2. Remit Membership fee of Rs: 50/-
  3. The Completeness of this form is the SOLE RESPONSIBILITY of the member.
    AIRGBC will reject this form if any of the mandatory fields(Name, Date of Birth, Sex, Fathers name, panchayat/ Wardname, Assembly Name or Photograph) are missing, even if a Reference Number has been Issued.
Image size should be (width X height) 240X320 and not more than 100KB.
State:
Lok Sabha :
Assembly :
Panchayath/Ward:
Assembly code :
Panchayath/Ward SL.No:
Booth No

Full Name

First Name:
Last Name:
Fathers/Husbands Name :
Date of birth:
Sex:
Male Female
Blood gp:
Profession:
Present address:
City/District :
Pin Code :
Category :
General SC ST OBC Minority
Mobile :
Qualification:
Email:
Languages Known :
Voter id / Aadhaar card:
Aadhaar Number :

Declaration: I wish to apply for the membership of the all india Rahul Gandhi Bridge Congress. I accept the Constitution of the All India Rahul Gandhi Bridge Congress and I declare that-

  • The Information given by me in this form and enclosures is true.
  • I am citizen of india.
  • I am not a member of any other political party.
  • I have never been convicted of any Criminal offences by any court

Select and Upload address proof provided

Date:
Signature/ Thumline Impression: