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Name/s: |
1) ___________________________ |
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Membership No/s: |
1) _______________ |
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2) ___________________________ |
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2) _______________ |
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Date of Birth: |
1) __________________ |
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2) __________________ |
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Change of
Address/Telephone No. (If any):
_________________________________________________________________
E-Mail address: ___________________________________________
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Paid Rs.
________________ /= Cash/Cheque No: ___________________ |
Date: ____________ |
Bank/Branch:
________________________________________________ |
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Official Receipt No:
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Secretary's Signature/Official |
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Treasurer's Signature |
Please note children
having reached the age of 18 years should apply for new memberships.
Membership Fee: Family Membership Rs. 2,000/=. Individual membership Rs.1,000/= Overseas membership US$20 |
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Member's Signature/Date |