Name(Individual members)/ Organisation Name(Organisational members)*
Gender MaleFemaleOthers
Address *
Taluka *
District *
State *
Pin Code *
Mobile *
Email ID *
Age*
Name of the Organisation (If any) *
Year of Registration [Organisation] *
Type of Organisation * SocietyTrustFarm BusinessProducer CompanyCooperativesOther
Total area of Land/ Farm (hectares or acres/ bighas/ guntas)*
Owned/ Leased Land*
Crops grown*
I am willing to assist the Association in the furtherance of its objectives by *