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Application Form
Registration - Mission Green
We are*
:
Individual
/ Farmer
/ Institution
/ School
NGO
/ Company
/ Govt Office
We will be pleased to be a part of Mission Green project of Nopasna
We will be interested in offering our land(s) for plantation
:
Yes
No
We will be interested in adopting trees
:
Yes
No
We will be interested in doing plantation on public lands
:
Yes
No
We will be interested to work for identifying lands for plantation
:
Yes
No
We will like to donate money Rs._____________ for this project.
:
We undertake to collect funds from others. Target Rs.___________.
:
Name of land owner
:
Address
:
City
:
Pincode
:
Contact person
:
Telephone Number
:
Mobile Number
:
Email ID
:
The details of the land which can be used for plantation are: Land area : _________ acres / sq. ft.
:
Type of land
:
Grassland /
Tree cover /
Hill slope
Flat land /
Totally barren
Water Supply
:
available, tank at site
/ available but no tanks
no water source nearby
others
:
Water tanks
:
ready at site /
will be arranged by land owner
to be arranged
Fencing
:
fully fenced /
partly fenced
fenced but needs repair /
No fencing
Pits: size 1’x1’x1’
:
ready /
will be made by land owner
to be made by volunteers
Manure and soil
:
ready at site /
will be arranged by land owner
The details of the person coordinating from Nopasna, Mission Green Team
Contact person
:
Mobile Number
:
Email ID
:
Address
:
City
:
Any other suggestions / ideas for the project
:
Date*
:
Place*
:
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