Celebrating Roots, Connecting Hearts
Name :
Date of Birth :
Father’s Name :
Address in Kerala :
Society in which residing or having Flat :
Present Address for Communication :
Residence Number :
Mobile Number :
E-Mail ID :
Occupation/Profession /Qualification (With Name of company and office phone number) :
Blood Group :
Family Details (Spouse and Children) (Pls Provide Name, Relation, DOB, Profession/Class in which studying etc.)
Whether applicant can devote time for MAGNa Work, If Yes in what specific field or activity :
Areas of Interests :
Mode of Payment :
Pls upload the payment details :
(Max 2 MB)
Pls upload your Passport Size Photo :
I have read the Rules and Regulations of the Association and I hereby solemnly undertake to abide by the same. The Membership fee is enclosed.
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