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NAIR SERVICE SOCIETY DELHI (Regd.) Regd. Office :Plot No.3, Institutional Area, Dwarka, Sector-11, New Delhi-110075 [Registered Under the Societies Registration Act - 1860 (XIII of 1860) Website : www.nssdelhi.org,www.n4nairmatrimony.com E-mail : [email protected], [email protected]

APPLICATION FORM FOR MEMBERSHIP

The General Secretary, Service Society Delhi (Regd.) New Delhi

Sir, I wish to enroll myself as a Member of the Delhi. I have read the Rules and Regulations of the Society and I hereby solemnly undertake to abide by the same. The Life Membership fee is enclosed. The required details are furnished below:

*Full Name (in Capital Letters) ......

*Date of Birth DD...... MM...... YY...... (Attach copy of Matriculation Certificate)

*Date of Birth ( Calendar) & Star ………………………………………………………………………………………………………..

*Father’s Name ......

* Address in ......

......

*Present Address for Communication ……………………………………………………………………………………………………………... (Attach copy of address proof and Identity proof) .……………………………………………………………………………………………………………...

*Tel. No. Res...... Mob......

*Office (Name of the Company & Address) ………………………………………………………………………………………………………..

..…………..……………..……………………………………………………………………………….

Occupation/Profession/Qualification ……………………………………………………………………………………………………………….

E-mail ID...... Ph.Off......

*Blood Group ...... Whether any court/police case is pending against you ……………………………

Family Details (Name of Wife &Children & their Age)......

......

......

Whether applicant can devote time for NSS Work......

If so in what specific field or activity?………………………………………………………………………………………………………………

*Areas of Interest......

(*mandatory fields to be filled)

Place …………………….. Yours faithfully

Date : ...... (Signature)

Encl. : Cash/Cheque No...... dt...... Bank...... drawn in favour of Nair Service Society Delhi (Regd.)

Bank Account No……………………………… ………. Branch………………………………….

I have known this applicant for the last...... years and I recommend that he may be admitted as a Life Member of the Society.

Recommended by a Member of NSS Delhi :...... (Signature)

Name, Address & Tel. No......

……………………………………………………………………………………………………………..

Area Chairman / Secretary Signature of the President NSS Delhi (Regd.) Secretary (Membership) General Secretary NSSDelhi(Regd.)

FOR OFFICE USE

Received an amount of Rs.1000/- Cash/ Cheque No...... on Bank of …………………...... Branch……………………………………. vide receipt No...... dated...... NSSDELHI MEMBERSHIP FORM 2013