MEMBERSHIP FORM
I wish to join “Savera Society for Human Initiatives” as a member.
1. Name..............................................................................................................
2. Father’s Name................................................................................................
3. Complete Address..........................................................................................
........................................................................................................................
4. Mob. No................................... E-mail............................................................
5. Sex..................................................................................................................
6. Date of Birth....................................................................................................
7. Educational Qualification................................................................................
8. Occupation......................................................................................................
9. Why do you want to join Savera Society for Human Initiatives
........................................................................................................................
Types of Membership
(a) Patron Member
(b) Whole Life Member
(c) General Member
|
Membership Fee
Rs. 2100/-
Rs. 1100/-
Rs. 200/-
|
Period
Whole Life
Whole Life
One Year
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NOTE:
· Fee may be paid by Cash/Cheque/D.D. in favor of ‘Savera Society for Human Initiatives’
· To know the vision, values & mission of Society, please visit the blog ‘www.saverango.blogspot.com’.
Signature of Applicant
DECLARATION: I hereby declare that all the information and particulars given by me in this application are true to the best of my knowledge and belief. I agree to immediately inform you if there is any change in any of the information given in this application. I also declare and agree that if any of the above statements are found to be incorrect or false or any information or particulars have been suppressed or omitted there from, I am liable to be dismissed / suspended from the society. I agree to abide by all the terms & conditions of the Society.
Signed this……….the day of………………..20
Place:
Signature of Applicant
Attach Following documents with Membership Form and send to our office address:
1. Two Copies of Residence Proof.
2. Two Photos (Passport Size)
E-mail: ngosavera@gmail.com, www.saverango.blogspot.com
