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BSSU
Bharat Shramik Suraksha Union
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Join Bharat Shramik Suraksha Union and stand united for workers' rights
Membership Application Form
Leader Name
Leader Name
1. Working & Work Location Details
Membership Category *
General Member (Active worker)
Associate Member (Support of worker movement)
Life Member (One time contribution)
Honorary Member (Nominated)
Sector
Select
Organised
Unorganised
Designation
Institution Name (If Organised)
Workplace
Occupation
Working Since
PF No.
ESI No.
2. Personal Particulars
Name *
Father's Name
Spouse's Name
Date of Birth
Marital Status
Select
Married
Unmarried
Gender
Male
Female
Other
Blood Group
Category
Select
GEN
SC
ST
OBC
Voter ID
PAN No.
Aadhaar Number
E-Shram Card No.
Mobile Number *
Email ID
3. Residential Address
Present / Working Address
PO
PS
District
State
PIN Code
Permanent Address
PO
PS
Dist
State
PIN Code
4. Bank & Nominee Information
Bank Name
Branch Name
Account No.
IFSC Code
Account Type
Select
Savings
Current
Nominee Name
Nominee Relation
Nominee DOB
Nominee Aadhaar
5. Educational Qualifications
1
2
3
4
5
Attachments
Photo
Signature
Thumb Impression
Biodata (PDF / Image)
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