ALL INDIA COUNCIL OF HUMAN RIGHTS, LIBERTIES & SOCIAL JUSTICE

Registered under the society registration act (xxi) 0f 1860 , govt of India , NCT , Delhi, vide regd no.: S/00837/NE
(Registered with planning commission of India vide - unique id: DL/2012/0050768) under partnership systems)

_______________________________________________________________

APPLICATION FORM
______________________________________________________________

COMMON MEMBERSHIP FOR (Please Tick _/ )

All India Council Of Human Rights , Liberties & Social Justice
National Council of News & Broadcasting (PRESS) (NCNB)
National Legal Council (NLC) ,(An unit of AICHLS)
All India Anti Corruption Council (AIACC) ,(An unit of AICHLS)
All India Consumer Protection Council (AICPC), (An unit of AICHLS)
International Institute of Human Rights Studies) IIHRS ,(An unit of AICHLS)

Submit the complete form with the following documents and send to us on the below address for selection

Selection process time 7/10 days

1.
2.
3.
4.
5.

4 Nos. Passport Size Photo

Address Proof & Photo ID Proof
DD/Bank Deposit/NEFT Slip For Your Document Preparation
Self Address Envelope ( A-4 Size ) With Complete Address , Mobile No. / Pin Code .
Paste your passport photograph with front face in all Forms.
_______________________________________________________________
CONTACT / POSTAL ADDRESS

SECRETARY GENERAL
All India Council Of Human Rights, Liberties & Social Justice
Central Office: H-10, Basement, NDSE - Part One , New Delhi 110 049
phone: 011 65152233, 9873087903, 9873005424
Email: humanrightscouncil.org@gmail.com
visit: www.humanrightscouncil.in , news : www.newsindiatoday.tv
www.facebook.com/allindiacouncilofhumanrights

ALL INDIA COUNCIL OF HUMAN RIGHTS, LIBERTIES & SOCIAL JUSTICE

Registered under the society registration act (xxi) 0f 1860 , govt of India , NCT , Delhi, vide regd no.: S/00837/NE
(Registered with planning commission of India vide - unique id: DL/2012/0050768) under partnership systems)

COMMON FORM FOR AICHLS/NLC/AICPC/AIACC

To,

Paste your
Photo
Here

Chairman
Central Selection Committee
New Delhi.

MEMBERSHIP FORM
(FILL THE FORM WITH CAPITAL LETTER ONLY)
Applicant Name (BLOCK LETTER)

: ___________________________________________

Fathers Name

: ___________________________________________

Date Of Birth

: ___________________________________________

Mobile

:________________

Email ID ( Capital Letter Only)

: ___________________________________________

Residence Address Permanent

: ___________________________________________

Postal Address Present (BLOCK LETTER)

Qualification

Landline with STD Code :_________

: ___________________________________________

: ___________________________________________

I declare, that I am joining the organization with my own acceptance and consent and not been forced by anyone and
want to help the organization to serve the society with dignity, will not do any illegal activity which against the
Indian law , Indian constitution and society

Please Provide Three References:

1. Name____________

Mobile__________

Relationship____________Email Id______________

2. Name____________

Mobile__________

Relationship____________Email Id______________

3. Name____________

Mobile__________

Relationship____________Email Id______________

Signature Applicant : _________________

Date ___________________

Official Use Only

The national selection committee has examined your all details and hereby approve / disapprove your Application
For The Membership.

Membership No.
Designation Granted

: ___________________________
: ___________________________

Signature /Date
Chairman (Selection Committee)

Signature/Date
National President/Chairman

ALL INDIA COUNCIL OF HUMAN RIGHTS, LIBERTIES & SOCIAL JUSTICE

Registered under the society registration act (xxi) 0f 1860 , govt of India , NCT , Delhi, vide regd no.: S/00837/NE
(Registered with planning commission of India vide - unique id: DL/2012/0050768) under partnership systems)

MUST ANSWER THESE QUESTION FOR VERIFICATION

What is your Email Id ( CAPITAL LETTER ONLY) : ________________________________
What is your exact Mobile No.

: ________________________________

What is your Land Line No. ( with STD Code)

: ________________________________

What is your profession :_______________________________________________________

Are you married or unmarried

: ________________________________

(If Married) : Spouse name

: ________________________________

How many kids do you have ?

: ________________________________

What is your objective to join this organization?

_____________________________________________________________________________
How do you want to serve the society?
_____________________________________________________________________________
How you came to know about us ?
_____________________________________________________________________________
Do you know any exisitng member in said organization If Yes ( Provide Name , Address ,
Mobile , Email Id. ) : ___________________________________________________________
_____________________________________________________________________________
Are you joining with your own consent? : Yes / No : _________________________________
Have you ever been pressurized by any existing member or anybody to become part of our
AICHLS/NCNB/NLC/AICPC/AIACC: Yes / No : ____________________________________

Have you ever been convicted by any court in India : Yes / No.: _________________________
Have you ever involved with any activity which is against the Indian Government / Government
Policy / Indian Law / Constitution: Yes / No. : _________________________________
Have you ever been involved with any human rights activity (Brief)
_____________________________________________________________________________
_____________________________________________________________________________
Continue >>>>>

ALL INDIA COUNCIL OF HUMAN RIGHTS, LIBERTIES & SOCIAL JUSTICE

Registered under the society registration act (xxi) 0f 1860 , govt of India , NCT , Delhi, vide regd no.: S/00837/NE
(Registered with planning commission of India vide - unique id: DL/2012/0050768) under partnership systems)

Are you ready to serve the society voluntarily / without Any remuneration / Commission / Salary
etc.? : Yes/ No : _________________________________
At what level (International/National/State/District/Block/ward/Taluka ) are you ready to take
responsibility & How many membership can you generate from your social network? :
_____________________________________________________________________________
Are you ready to make your working / action committee at the earliest : Yes/ No : _________
within how many days? : _________
Are you suffering with any kind of disease: Yes/ No : _________________________________
Are you ready to submit all your written report every month: Yes/ No : ___________________
What is the issue which you want to work in the said organsiation ? (Ex. Child Labor, Education Etc.)
_____________________________________________________________________________
Have you made any donation /contribution in said organsiation ? Yes / No
If Yes ( Please mention the amount)
: Rs. _________________________
(In Word : Rs. ___________________________________________________________)
Mode of Payment (Cash/Cheque/DD/PO)

: ____________________________

Collected by (Name of person & Mobile No.)

: ____________________________

Have you asked to pay Cash /Cheque/DD/PO

: ____________________________

How much have you paid for your documentary charges : Rs. _____________________
DECLARATION: I hereby solemnly affirm and declare that The particulars mentioned by me here in
above are true & correct to the best of my knowledge and belief and nothing has been concealed or
suppressed thereof. If anything found incorrect at any stage, my membership may be terminated. I
honestly declare that I will not involve myself directly or indirectly in any act which will be against the
prestige of our Indian Policy , Indian Government , Nation , Constitution , Indian Laws, Society,
Journalism and AICHLS/NCNB/NLC as well. I will abide by the rules and regulations and Byelaws of
the AICHLS/NCNB/NLC in force from time to time.
Signature (Applicant only)
Name_____________________ Date____________Location_________Mobile ___________________

_____________________________________________________________________________

NATIONAL COUNCIL OF NEWS & BROADCASTING

Registered under the society registration act (xxi) 0f 1860 , govt of India , NCT , Delhi, vide regd no.: S/00810/NE
(Registered with planning commission of India vide - unique id: DL/2012/0050768) under partnership systems)

To,
Chairman / Editor in Chief
Central Selection Committee

MEMBERSHIP FORM

Paste your
Photo
Here

(FILL THE FORM WITH CAPITAL LETTER ONLY)

Applicant Name

: _______________________________________________________

Fathers Name

: _______________________________________________________

Date Of Birth

: _______________________________________________________

Mobile

:________________ Landline with STD Code :________________

Email ID ( Capital Letter Only)

: _________________________________________

Residence Address Permanent

: _________________________________________

Postal Address Present (BLOCK LETTER)

Qualification

: _____________________________

: _________________________________________

I declare, that I am joining the organization with my own acceptance and consent and not been
forced by anyone and want to help the organization to serve the society with dignity, will not do
any illegal activity which against the Indian law , Indian constitution and society
Please Provide Three References :
1. Name____________ Mobile__________

Relationship____________Email Id______________

2. Name____________ Mobile__________

Relationship____________Email Id______________

3. Name____________ Mobile__________

Relationship____________Email Id______________

Signature Applicant : _________________

Date ___________________

Official Use Only

The national selection committee has examined your all details and hereby approve / disapprove
your Application For The Membership.
Membership No.
Designation Granted

: ___________________________
: ___________________________

Signature /Date
Chairman (Selection Committee)

Signature/Date
National President/Chairman

ALL INDIA COUNCIL OF HUMAN RIGHTS, LIBERTIES & SOCIAL JUSTICE

Registered under the society registration act (xxi) 0f 1860 , govt of India , NCT , Delhi, vide regd no.: S/00837/NE
(Registered with planning commission of India vide - unique id: DL/2012/0050768) under partnership systems)

(OATHS/ACCEPTANCE/DECLARATION (ONLY AICHLS/NCNB/NLC/AICPC/AIACC APPLICANT)

To, Chairman
Central Selection Committee

Paste your
Photo
Here

Dear Sir,
I_______________________S/o_________________ Residence of _______________ Solemnly
take oaths / accept and declare:
1. That I am joining and subscribing AICHLS/NCNB/NLC/AICPC/AIACC with my own consent
without
any
force
or
pressure
from
any
existing
member
of
AICHLS/NCNB/NLC/AICPC/AIACC or from any source related to the Org.
2. That I shall render my all services to the AICHLS/NCNB/NLC/AICPC/AIACC free of cost on
voluntarily basis, without claiming any kind of payments or service charges or expenses.
3. That I shall be fully dedicated to Human rights, Liberties and social Justice for the people &
society and not for individual or my own benefits.
4. That I shall not misuse the name of AICHLS/NCNB/NLC/AICPC/AIACC for my own sake and
benefits Strictly, if found liable to face action by CENTRAL DISCIPLINE ACTION
COMMITTEE OR NATIONAL PRESIDENT, which is final.
5. That I shall pay all my membership fee , joining fee , Contribution, subscription in time and with
my own acceptance , consent and agreement.
6. That I shall obey and respect the code of conduct and constitution of the
AICHLS/NCNB/NLC/AICPC/AIACC in all mode and all time.
7. That AICHLS/NCNB/NLC/AICPC/AIACC shall not be responsible , for any kind of my illegal
activities, court cases, functions, seminars , rally which against the Indian Government /
Government Policy / Indian Law / Constitution/ society, knowingly or unknowingly and I
shall be terminated from AICHLS/NCNB/NLC/AICPC/AIACC by immediate effect, without any
notice and accept the final decision of the CENTRAL DISCIPLINE ACTION COMMITTEE OR
NATIONAL PRESIDENT.
8. That I shall authorize AICHLS/NCNB/NLC/AICPC/AIACC to put my name & details on the
website i.e. www.humanrightscouncil.in or any related social site or web site.
9. That I shall attend all meetings of the AICHLS/NCNB/NLC time to time in my respective
jurisdiction.
10. That I shall the serve the AICHLS/NCNB/NLC/AICPC/AIACC with whatever responsibility and
accountability given to me.
11. That I understand, my membership is non-transferable , provisional and once the payment is
made, it is non-refundable.
Continue on 2nd page

ALL INDIA COUNCIL OF HUMAN RIGHTS, LIBERTIES & SOCIAL JUSTICE

Registered under the society registration act (xxi) 0f 1860 , govt of India , NCT , Delhi, vide regd no.: S/00837/NE
(Registered with planning commission of India vide - unique id: DL/2012/0050768) under partnership systems)

12. That mine any kind of misbehavior or misconduct or anti society activity may result in
rejection/termination of my membership of AICHLS/NCNB/NLC/AICPC/AIACC.
13. That I shall renew my membership within 30 days immediately after expiry. In case of change of
address, I will inform the same to the National Administration Office .
14. That in case of loss of the identity Card, I will inform the Police Station , National Administration
Office in writing along with the F.I.R. immediately.
15. That being member of AICHLS/NCNB/NLC/AICPC/AIACC , shall contact my respective Area
Units / State Units / National Administration Office once in a month and send a written report /
Email.
16. That I am ready to face Strict action , if found guilty floating the rules and regulations of
AICHLS/NCNB/NLC/AICPC/AIACC, and are also punishable under the Press & Societies Act.
17. If I am holding the press ID card , I will report all the incidents immediately to the NCNB and
voluntarily.
18. If I am holding the Legal ID card , I will serve the people absolutely free and voluntarily and
provide free legal advice time to time.
19. If I have any doubt, question or problem, will contact AICHLS/NCNB/NLC/AICPC/AIACC
National
Administration
Office
with
the
All
rights
reserved
to
AICHLS/NCNB/NLC/AICPC/AIACC.
20. That my membership / designation / position are provisional , but membership shall remain valid
for 12 months as given your ID card.
21. That all disputes subject to Delhi Jurisdiction only.
22. That I shall take pre-approval from Delhi Head office before doing any correspondence with
Government / Local Administration.
23. That I have not been convicted by any court in India.
DECLARATION: I hereby solemnly affirm and declare that The particulars mentioned by me here in
above are true & correct to the best of my knowledge and belief and nothing has been concealed or
suppressed thereof. If anything found incorrect at any stage, my membership may be terminated. I
honestly declare that I will not involve myself directly or indirectly in any act which will be against the
prestige of our Indian Policy , Indian Government , Nation , Constitution , Indian Laws, Society,
Journalism and AICHLS/NCNB/NLC as well. I will abide by the rules and regulations and Byelaws of
the AICHLS/NCNB/NLC in force from time to time.
Signature (Applicant only)

Name_____________________ Date____________Location_________Mobile ___________________

Signature (Reference only)

Name_____________________ Date____________Location_________Mobile ___________________

ALL INDIA COUNCIL OF HUMAN RIGHTS, LIBERTIES & SOCIAL JUSTICE

Registered under the society registration act (xxi) 0f 1860 , govt of India , NCT , Delhi, vide regd no.: S/00837/NE
(Registered with planning commission of India vide - unique id: DL/2012/0050768) under partnership systems)

PERSONAL DETAIL FOR MAKING DOCUMENTS

COMMON FORM FOR AICHLS/NCNB/NLC
Kindly fill the details with CAPITAL LETTER, we will not responsible for any spelling mistake their
after , I am giving my particulars to make my Identity Card / Certificate / Car Sticker etc. as

details are given below , I am fully responsible for any spelling mistake if found in this slip and I
have submitted my full documents charges ( Voucher Details attached)

ONLY CAPITAL LETTER TO BE FILLED ( EMAIL ALSO :

(humanrightscouncil.org@gmail.com )

Applicant Name

: _________________________________________________

Fathers Name

: _________________________________________________

Spouse Name

: _________________________________________________

Date Of Birth

: _________________________________________________

Mobile

: _________________________________________________

Landline with STD

: _________________________________________________

Email ID (Capital Letter Only) : : _________________________________________________

Blood Group : _________________________________________________________________
Emergency Contact No : _________________________________________________
Complete Residence Address Permanent with pin code
______________________________________________________________________________
______________________________________________________________________________
Complete Residence Address Present with pin code
______________________________________________________________________________
Write your Complete Address with pin code (For Delivery The Documents))
______________________________________________________________________________
______________________________________________________________________________
Name_____________________ Date____________Location_________Mobile ___________________

ALL INDIA COUNCIL OF HUMAN RIGHTS, LIBERTIES & SOCIAL JUSTICE

Registered under the society registration act (xxi) 0f 1860 , govt of India , NCT , Delhi, vide regd no.: S/00837/NE
(Registered with planning commission of India vide - unique id: DL/2012/0050768) under partnership systems)

Expense Slip (Treasury dept)

Documents & Administrative Charges (Must mention)
Particulars (Documentary Charges)

Amount

All India Council Of Human Rights , Liberties & Social Justice

Rs. 1175/-

All India Identity Card (Plastic) and Certificate. (AICHLS)

National Council of News & Broadcasting (PRESS) (NCNB)

Rs.

www.newsindiatoday.tv

975 + 2125

All India PRESS REPRESENTATIVE CARD and Certificate.

= 3100 /-

National Legal Council (NLC)

Rs. 1575/-

(A Legal Unit / Wing of All India Council Of Human Rights , Liberties & Social Justice)

All India Identity Card (Plastic) and Certificate.

All India Anti Corruption Council (AIACC)

Rs. 1275/-

(An Anti Corruption Unit / Wing of All India Council Of Human Rights , Liberties & Social Justice)

All India Identity Card (Plastic) and Certificate.

All India Consumer Protection Council (AICPC)

Rs. 1375/-

(A consumer protection Unit / Wing of All India Council Of Human Rights , Liberties & Social Justice)

All India Identity Card (Plastic) and Certificate.

Car / Bike Sticker (Cost per sticker)

Rs. 225/-

International Institute of Human Rights Studies ) IIHRS

(A Educational Wing of All India Council Of Human Rights , Liberties &
Social Justice) , provides Diploma as a HONOUR

Diploma Human Rights (Honour) No Examination

Post Graduate Diploma (Honour) No Examination
Special Donation
Special Contribution
Donation for eye operation/food/medicine/orphanage/old age
etc.

Rs. 3100/Rs.5100/-

Dated Bank Drawn

ALL INDIA COUNCIL OF HUMAN RIGHTS, LIBERTIES & SOCIAL JUSTICE

Registered under the society registration act (xxi) 0f 1860 , govt of India , NCT , Delhi, vide regd no.: S/00837/NE
(Registered with planning commission of India vide - unique id: DL/2012/0050768) under partnership systems)

Kindly Note :
1. All Contribution /Donations movable or immovable exempted granted registration under
section -80 (G) (5) (vi) & 12A of the Income Tax Act, 1961 by the Directorate of Income
Tax (Exemptions), New Delhi
2. Kindly speak to us for press card before applying at Editor - 98730 87903
3. Kindly note that we do not accept or receive Cash, inform us if anyone is asking for Cash
98730 87903 or Email : humanrightscouncil.org@gmail.com.
4. After receiving the sets of documents, Kindly send the photocopy of your documents at
Delhi Office and must check your name on our web site (www.humanrightscouncil.in ) ,
if not there kindly intimate us / Email : humanrightscouncil.org@gmail.com.
5. Primary membership is Free only documents making and administrative charges to be
paid as given above , which is non refundable.
6. Read all our aims , objectives, achievements , Roles & Responsibilities in ABOUT US
column.(www.humanrightscouncil.in)
7. Contribution /Donations/Fees Etc. To Be By DD/PAY ORDER In The Favour of ALL
INDIA COUNCIL OF HUMAN RIGHTS,LIBERTIES & SOCIAL JUSTICE and
NATIONAL COUNCIL OF NEWS & BROADCASTING payable New Delhi
FOR ALL INDIA COUNCIL OF HUMAN RIGHTS, LIBERTIES & SOCIAL JUSTICE

INDIAN BANK:
Saving A/c No. : 6106 880946 payable New Delhi
Branch Address: South Extension -I, New Delhi
CBS Code: 00361 - IFS Code: IDIB000 S032
HDFC BANK - Branch Defence Colony - New Delhi
Saving A/c No. : 1092 145 0000069 payable New Delhi
RTGS/NEFT IFSC : HDFC0001092
Online Transfer: Please email us the transit number of online transfer
FOR PRESS REPRESENTATIVE CARD
NATIONAL COUNCIL OF NEWS & BROADCASTING
HDFC BANK - Branch Defence Colony - New Delhi
Saving A/c No. : 1092 145 0000052 payable New Delhi
RTGS/NEFT IFSC : HDFC0001092
8. If Depositing Money or NEFT in the bank, mail us your deposit /NEFT details at
humanrightscouncil.org@gmail.com
9. FOR ANY QUERY : 9.00AM TO 9.00 PM : 9873005424 / 9873087903