Request Membership – St. Mary's

Request Membership

Account Details

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Profile Details

Full Name (required)

Write your Full Name (Fist and Second Name)

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Ward (required)

Please select the Ward allotted to you

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If Dependent Member, write Main Member's Name

KEEP IT BLANK IF YOU ARE THE MAIN MEMBER If Dependent Member, Please write the Main Member's Name Eg:- Father's Name / Husband's Name... etc.

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Current Address Line 1 (required)

Write your Ahmedabad Address

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Current Address Line 2 (required)

Write your Ahmedabad Address Line 2

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WhatsApp Number (required)

No Country Code, just your WhatsApp Number

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Second Number (if any)

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Pin Code

OPTIONAL: Enter six digit Postal Code

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City (required)

Select name of City (Ahmedabad is default)

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Date of Birth (required)

like "1970" or "2018" (YEAR ONLY VISIBLE TO YOU, other member's can't see)

Day Month Year

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