Registration Form
Please Fill this form to Show your Support to Anna Hazare's Movement Against Corruption
(India Against Corruption), to pass a strong Anti-corruption law (Janlokpal).
Note:Volunteer registration is different.
Full Name*
Contact Number:
E-mail Will keep you updates By mails
Area/ Locality*:
Age
I can Support the movement By*
·
Volunteer
·
Financial Help to Movement (Donation)
·
Participate in Activities
·
Other:
Your Suggestions for the Movement You can write your suggestion below to make this
movement a success.
Registration for Current Events (Second Battle of Independence) * Pls use this for Fasting
& other Event Registration.
·
Indefinite Fast from as and when required
·
Relay Fast
(24 hour)
·
Token day Fast (6:00am to 6:00pm)
·
Participate in Motorcycle/Car Rally
·
Volunteer (Non - Fasting)
·
Ready for Jail Bharo Andolan
·
Just want to support the movement and help spread the word
Contribution To the movement (Not Compulsory)*please select appropriate field to contribute
your Time/Money/ Mind to the event
·
I can Sponsor publicity material (pamphlets,badges,stickers,flex, banner etc.)
·
I will contribute by Providing Water pouches
·
I can Contribute by donation to the movement.
Contact
For more details please mail us at : [email protected] or call us
at 08092887211;09546772436
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