Media Form

Name

Last Middle

Last Name

Father Name

Father's Middle Name

Father Last Name

Mobile No

Date Of Birth

Anniversary Date

Present Addddress

Permanent Addddress

Education

Other Qualification

Marital status

Children

News Paper Name

Joining Your

News Paper Name

Agency Name

City

Sate

Designation

Personal Des

Hight

Weight

Complexion

Indentity Marks

Languages

Vehicles

Two Wheeler Mark

Model

Registration No

Four Wheeler Mark

Model

Registration No

Nearest Railway station

Nearest Police station

Business Add

Pan No.

M/S

Business Add

City

State

Pin Code

STD Code

Email Id

Fax No.

Mobile No

Proof Of Identity ( Any One Adhar, Possport, V.I.D Card, Pan Card, D.L )

Uplode

Proof Of Address ( Any One (Ration Card) , Ph / Electricity / Water Bill / Edu Certificate Bank Statement )

Uplode

Introduced By

Shri.Smt

I.D No

Sugnature

Uplode

M.s.News Designation

Please Enclosed Photocopy of Above Mentioned ID/Address Proof , 4 Recent Passport Size Photograph
Identity Card and Other Material Will be send With in 15 Days After Resivinge This Application Fome
The Ammount 1500(One-Thousand-Five-Hundred only) is for one year of Membership in favour of "M S NEWS" (REGD). Delhi

Payment Info

Rs.1500