Membership Application Form | RDCG Progressive Citizens Social Associations

1. Personal Details

Candidate Name *

Father's Name *

Mother's Name *

Date of Birth *

Blood Group

Gender *

Category *

Nationality *

Recent Passport Photo *

Upload Photo

Max 5MB (JPG, PNG, WebP)

Permanent Address *

Contact No *

Alternative Contact No

Email ID *

Create Portal Password *

Password Security Requirements:

12+ Characters Uppercase (A-Z) Lowercase (a-z) Number (0-9) Special Symbol (!@#$)

This password will be used to log into your Member Dashboard.

2. Location & Geographic Details

State *

District *

Sub-division / Tehsil

Block (Rural)

Grampanchayat (GP)

Municipality (Urban)

Ward Number

Pin Code *

3. Education Qualification

Examination	Stream / Subject	Board / University	Passing Year	% Marks / Grade
10th / Secondary
12th / Sr. Secondary
Graduation (BA/BSc/BCom/BTech)
Post Graduation / Others

4. Employment Status & Experience

Select Employment Status *

Work Experience

Project Work Experience (If Any)

5. KYC Details & Document Uploads

Identity Proof Type *

Identity Proof Document Number *

ID Front-Side Upload *

Front side of Aadhaar / Voter / DL

ID Back-Side Upload *

Back side with address

Communication Address Proof Type (Optional)

Address Proof Number (Optional)

Address Proof Front-Side (Optional)

Address Proof Back-Side (Optional)

Applicant Signature Upload *

Sign on blank white paper & upload photo

Signature Preview

6. Referral Programme

Referral Code (Optional)

If you were referred by an active Coordinator or Member, enter their ID here.

7. Bank Details

Bank Name *

Bank Account Number *

IFSC Code *

UPI ID (If available)

8. Membership Plan & Payment Options

Select Preferred Membership Plan *

Select your preferred membership tier to view applicable registration fee.

Applicable Registration Fee: ₹1,216.00

Standard (Yearly)

Payment Mode: Instant Online Payment (Razorpay Gateway)

Renewal / Billing Frequency

One-Time Payment

Recurring AutoPay (Hassle-Free Annual Auto-Renewal)

Choose AutoPay for seamless automatic membership renewal, or One-Time to pay manually each cycle.

Mandatory Applicant Declarations: I confirm that the information provided by me is true and correct. I agree to the Terms and Conditions, Privacy Policy, and applicable membership rules and regulations.

256-Bit SSL Encrypted

Bank Name:
Account Number:
IFSC Code:
Account Name:	RDCG Progressive Citizens Social Associations

Application for Registration Only

RDCG Progressive Citizens Social Associations

Official NGO Bank Details for Direct Transfer