AGCART - INDIA PVT LTD

Online Membership Registration Form

Please fill up the online registration form.

Fields marks with (*) are mandatory

Apllicants Personal Details:

Full Name *

Father's / Spouse Name *

Gender *

Date of Birth *

Email ID

Contact Number *

Aadhar Number / Voter Card Id *

Pancard Number

Full Corresponding Address *

Farm Details:

State *

City *

Taluka/Tahasil *

Village *

Survey/Gat No/ 7-12 *

Total Land Holding (in acres) *

Contract Farming Details:

Select Product for Contract Farming *

Previously Grown Crops *

Soil Type *

Red Soil

Black Soil

Water Source *

Irrigated

Non Irrigated

Proof of Payment:

Transaction Reference No/UTR No *

Date of Payment (DD/MM/YYYY) *

Amount of Registration Fees *

I hereby declare that the above information is true and correct to the best of my knowledge. I agree to abide by the terms and conditions of the Contract Farming Services offered by AGCART India Pvt. Ltd.