Membership Form

Members	Membership Fee £500	Burial Cost £500
Non-Members	Burial Cost £1300+£500

New Members - membership commences 14 days after payment
Wife, mother & sister covered under husband, father or son. No membership fee required. Burial Cost £500
All male 17+ are required to become a member, and not convered under any other membership

Name of Applicant: (required)

Address : (required)

Post Code : (required)

Village in India:

Date of Birth: (required)

Phone:(required)

Email: (required)

Father’s Name:

Mother's Name:

Wife's Name:(required)

Emergency Contact

Name:

Contact:

1) Children Name :

DOB :

Gender :

Phone :

I consent to having this website store my submitted infortmation.