Membership Form :

Just fill out and print off the following form, then mail it to the address at the bottom of the page.
Yes, I would like to give to the Bal Vikas Yuva Samarpan Sansthan (BVYSS) I would like to give a gift of Rs._________ ___________________ to help the people.
If you would also like to become a member of Bal Vikas Yuva Samarpan Sansthan (BVYSS)
.
Name(s)
Organization
(if applicable)
Address
Country
Postal Code/
Zip Code
Phone (H)
Phone (W)
E-mail
Website
Check enclosed 
(Please make cheques payable to the
"Bal Vikas Yuva Samarpan Sansthan" Gorakhpur)
Credit Card (VISA, MASTER, ICICI, SBI) 
Credit Card Number
Expiry Date (Month/Year)
Signature ___________________________
 
For VISA payments, we must have your original signature.
Please print this form and send us your donation by mail.
 
I would like to help
in other ways: 
Volunteer/in-kind professional services
Other ideas?
Thank you for supporting Bal Vikas Yuva Samarpan Sansthan (BVYSS)

If you are paying by VISA, please mail your form to:
Registered Office :
Bal Vikas Yuva Samarpan Sansthan (BVYSS)
0063-A, 'Sneh Sadan', Keshawpuram, Gorakhnath
Gorakhpur - 273015 (U.P.) India.