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Membership Application

Please fill in the application form given below...

The Secretary,
DLF City Durga Puja and Bengali Cultural Society
C-1657, Sushant Lok I,
Gurgaon, Haryana
India
PIN  - 122002

Dear Sir,
Please enroll me as member of DLF City Durga Puja and Bengali Cultural Society. I'm furnishing below the details of my family.

[All fields with "" are mandatory]

Title:

Name:

Father's Name:

Age:

Address:

Permanent Address:

Occupation:

E-mail:

 

Tel. (Res.):

Tel. (Off.):

Mobile:

Details of Family Members:

S.No. Name Age Relationship Sex Occupation & other details
1.
2.
3.
4.
5.

Declaration:

I confirm, I shall abide by the rules and regulations of the society as specified in the "Memorandum of Association and Rules & Regulations of the Society". The above particulars furnished by me are true to the best of my knowledge and I shall keep the society informed of any change in the future.

Membership Proposed By:

Membership Seconded By:

Type of Membership:

Processing Fee: Rs. 100.00 [Application for both, Term as well as for Life Membership]
Term Membership Fee [For 3 Yrs.]: Rs. 1000.00
Life Membership Fee: Rs. 3000.00

Your membership will be processed on receipt of required fees. Please send in your application fees to General Secretary by cheque or demand draft drawn in favour of "DLF City Durga Puja and Bengali Cultural Society".



 
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