BENEFICIARY REGISTRATION FORM

Please fill the Details of Applicant - Who will open the Canteen

Widow Retired Family Others

Select store category

Grocery Electronics grocery+electronics

Reference Id (Optional) Reference Name (Optional) Applicant Name * Father Name * Force Number (Optional) Unit Office (Optional) Force Name (Optional) Rank (Optional) Email Id * Mobile No * Alternate Mobile No * Date of Birth * Date of Enlistment (Optional) Date of Retirement / Discharge (Optional) Education Qualification * Employed / Unemployed * Country * State * District * Tehsil * Pincode * Size of Canteen Square Feet * Address * Canteen Location Address *

Please Deposit Registration Fee of Rs5000

RAKSHAK SAINIK CANTEEN
Ph number: 7079771191
E-mail: rakshaksainikcanteen@gmail.com
address: Nayka barka baiju tola
ward no- 16
po+ps- revelgang
district- saran
pin- 841305
Bihar

Note: Registration fee not refundable