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Application Form for Regular Donation Bharat Jagriti Mission

To,
Bharat Jagrat Mission
# Railway Road,
Jwalapur, Hardwar,
Uttarakhand - 249407
INDIA

Dear Sir,

I am associated with Bharat Jagriti Mission and I came to know about the various types of charities. Thus, I/We would like to contribute a regular amount for the furtherance of the aims and objects of Bharat Jagriti Mission by giving:

  Monthly
Rs. 100/-  Rs. 200/-   Rs. 500/-   Rs. 700/-    Rs. 1000/-
Rs. /-
  Quarterly
Rs. 100/-  Rs. 500/-   Rs. 1000/- Rs. 2000/-  Rs. 3000/-
Rs. /-
  Half-yearly
Rs. 500/-  Rs. 1000/- Rs. 2000/- Rs. 5000/-  Rs. 6000/-
Rs. /-
  Annually
Rs. 500/-  Rs. 2000/- Rs. 5000/- Rs. 10000/- Rs. 12000/-
Rs. /-
     
     
  Mode of Payment:
     
  Type of Charity
     
  Contact Details  
  First Name
  Last Name
  Address Line 1
  Address Line 2
  Address Line 3
  City
  State / Province
  Country
  Zip / Postal Code
  Email
  Telephone No.
   

 

 

 

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courtesy : BHARAT JAGRITI MSISSION
Railway Road, Jwalapur, Haridwar, Uttarakhand, India
Tel : 01334-310300, 324939, email : shrigangaji@indiatimes.com