Common Cause

Slideshow 2!

Seminar on Local Self Government- An Unfinished Agenda

1. Name:

2. Father's name:

3. Mother's name :

4. Date of birth:

5. Educational Qualification:

6. Occupation:

7. Permanent Address:

8. Contacts

a. Mailing Address:

b. Email ID :

c. Telephone Nos

9. Next of kin (Name & Address):

10. Membership sought. ( Tick any one block ):

New Individual Members (with voting rights)	Ordinary - Rs 500/- p.a	Life - Rs 2500/-
New Associate Members (without voting rights)	Ordinary - Rs 100/- p.a	Life - Rs 500/-

11. Why do you wish to join COMMON CAUSE (upto 80 words)

12. Your expectations from COMMON CAUSE (upto 40 words)