APPLICATION FORM FOR MEMBERSHIP    

(see Rules and regulations 2.0 of All India ASECA – Regn. # S-30626-1996)

The President/General Secretary,

All India ASECA,

SFS Flat No. 326, Pocket 10

Sector 11 (Extension), Rohini, Delhi - 110 085

Dear Sir,

I desire to become a life member of this Association. I am giving below information in brief about myself. I shall furnish additional information if required. I shall abide by the rules and regulations of the Association.

  1. NAME (IN BLOCK LETTERS)         _______________________________________________
  2. FATHER’S NAME                             _______________________________________________
  3. DATE OF BIRTH (d-m-y)                  _______________________________________________
  4. PERMANENT ADDRESS WITH

    CONTACT # IF ANY                         _______________________________________________

                                                                _______________________________________________

  5. PRESENT ADDRESS WITH

    CONTACT # IF ANY                         _______________________________________________

                                                                _______________________________________________

  6. EDUCATIONAL QUALIFICATION _______________________________________________
  7. AREAS OF INTEREST                      _______________________________________________
  8. OCCUPATION /PRESENT JOB

    (DETAILS OF THE PRESENT

    JOB WITH ADDRESS)                    ________________________________________________

                                                               _______________________________________________

  9. MEMBER OF ANY OTHER

    ASSOCIATION IF YES GIVE

    DETAILS                                            ________________________________________________

  10. INDICATE YOUR OPTION FOR

    PAYMENT OF MEMBERSHIP

    FEE OF Rs2011/- (*)                          _______________________________________________

  11. ANY OTHER INFORMATION         _______________________________________________

    Date:_____________

    Place:____________                                                                                                                             (Signature)

* It may be one time or the applicant member may indicate his plan of payment. Drafts/Cheques may be drawn in favour of All India ASECA, New Delhi in Savings Bank A/c # 076201000014827 at Indian Overseas Bank, Jeevan Deep Building, Parliament Street, New Delhi, IFSC IOBA0000762

FOR OFFICE USE ONLY

The applicant has been introduced by _____________________ and his application has been/has not been approved in the ________________ meeting held on ___________. He should be informed accordingly.

 

(Signature of President/Gen. Secretary)

    Name:

Date :


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Copyright © 1996 All India ASECA. All rights reserved.
Revised: November 14, 2002