Date: ___________ Sr. no: _________
I ________________________ son/daughter/wife of __________________________
resident of __________________________________________________________
born on (mm/dd/yy) ________________________ at________________________ .
wants to be a primary member of Nationalist People's Front.
1. I have completed 18 yrs.
2. I am a registered voter of India.
3. I have complete faith in the principles of Nationalist People’s Front.
4. I am associated with any other political party (Yes/No): _____
If yes, name of political party: __________________________
________________
Applicant’s Signature
Applicant’s Name and Address: _______________________________
_______________________________
_______________________________ |
