Membership Form

 
To become a pride member of our Mushroom Circle you are required to fill up the form below. Kindly submit your passport size photograph along with the form. We charge a membership fees of Rs. 1500/- (Rupees One thousand five hundred) per year which you can pay through bank transfer or pay at later stage. Subsequent to the form submission we will provide you the membership Identity Card.
Name* :
Father's Name :
Present Address* :
Permanent Address :
Mobile No* :
Email Id* :
Facebook Public URL :  What's this?
Date Of Birth* : (Click on the icon to enter your date of birth)
Blood Group* :
Profession* :
Interest In Photography* : Portrait/people
Street
Wildlife
Events/Wedding/Indoor/Outdoor
Abstract
Fashion
Land Scape
Macro
Nature
Other
Type of camera Used* : DSLR
Point & Shoot
Phone
Other
Camera Brand Used* : Nikon
Cannon
Sony
Other
Camera Body Used* : (ex : Nikon D3100, canon D600 etc. etc.)
Membership Fees* :  Online Bank Transfer  Pay Later (Cash/Cheque)   (Amount:- Rs.2000 Per Year)
Your Passport Photo (for I card)* : (Note: Upload Photo Upto 1MB)
How Do U Know About Us * :
  I have read and agree to the terms and conditions for membership*

This question is for testing whether you are a human visitor and to prevent automated spam submissions. Math question*:
5 + 4=
Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.
 
 

Online Transfer through NEFT:



You can transfer the amount to Mushroom's bank account. Please find the details below -
Bank - State Bank of India
A/C Name - Mushroom
A/C No - 33286590951
IFSC - SBIN0010930
Branch - Vivekananda Marg, Bhubaneswar
 
Benefits of Membership
.You can attend photowalks, workshops, field trips and much more.
.Showcasing and discussing about your work for improvements within our circle.
.Your photographs will be reviewed by a team of photography experts and professionals.
.You can share and gain a lot of knowledge from our experienced Photographers and other members.
.You can participate and win in our Monthly Photography Competition.
.You will get the chance to showcase your Photographs in the numerous exhibitions which we conduct periodically throughout the year.
.There are many other benefits and advantages for all the member of our community....
 
Note:-For Registration/Other Queries Contact
Administrator :
   
Accounts & Administration : Mr. Sumon Sinha
Contact No : 08018569653
Mr. Jitendra Pati
Contact No : 9937416333
   
Photography Tours & Trips :Mr. Rajeev Rout
Contact No : 9583426063
Mr. Sidhartha De
Contact No : 9692452636
   
Photography Activities :Mr. Sidhartha De
Contact No : 9692452636
Mr. Sanjit Pattnaik
Contact No : 9861125352

   
Promotion & Outdoor Activities :Mr. Rashmi Ranjan Sahoo
Contact No : 9437119067
Mr. Sanjit Pattnaik
Contact No : 9861125352
 
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