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