APPLICATION FORM FOR MEMBERSHIP OF COMMON CAUSE.
1. Name: |
6.Occupation: | ||||
2. Father's name: | 7.Permanent Address: | ||||
3. Mother's name |
8.Mailing Address: | ||||
4. Date of birth: |
|
||||
5. Educational Qualification: |
9. Next of kin (Name & Address): | ||||
10. Membership sought. ( Tick any one block ): |
|||||
Individual : |
Ordinary | Life | |||
(with voting rights) | (Rs.500/- p.a.) | (Rs.2,500/-) | |||
Associate : |
Ordinary | Life | |||
(without voting rights) |
(Rs.100/- p.a.) | (Rs.500/-) |
11. Why do you wish to join COMMON CAUSE (upto 80 words)
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
12. Your expectations from COMMON CAUSE (upto 40 words)
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
Place & Date: Signature