CHANGE LIFE FOR GOOD

Registration Form For NGO

(*) FIELDS ARE MANDATORY:

Name of the NGO *

Membership No. *

Date of Establishment *

Phone No. *

E-mail *

Address *

City *

Panchayat

Block

Village

Select District * Please Select District Indore Riva Satna Katni

Select State * Please Select State Andhra Pradesh Arunachal Pradesh Assam Bihar Chhattisgarh Goa Madhya Pradesh

Select Country * Please Select Country * Indore Riva Satna Katni

Contact Person *

Contact No. *

Mail Id *

PAN No.*

Area of Work *

Attach Following Documents :

Registration Certificate * :

copy of 12 A :

Copy of 80G :

Copy of FCRA :

Audit Report(14-15) :

Audit Report(13-14) :

Audit Report(12-13) :

Amount of Funding Required :

Project Report for Funding :

We here by agree to the Terms & Conditions of Mahim Bundelkhand Utthan Samiti

We here by undertake that all the informations submitted are true and correct to the best of my knowledge & belief.