MISSION SAROMAYO
Integrated Street Dog Rehabilitation Programme

                                                                                                             

MISSION SAROMAYO.                   

MEMBERSHIP  APPLICATION FORM

 

Name : ____________________________________________________________________________                                

                      Surname                            Middle Name                       First Name.

 

Occupation:________________ Age (if below 18 years)_____ School:________________________

 

Name of Father/Mother(for Minors).______________________________ Occupation____________

      

 

Telephone Nos:_____________________________E.Mail Address:_________________________ 

 

Possession of Dog/s _____No/s.  Pedigreed_____ No/s  Indian____No/s. Ages_______________   

 

Time Donation for the Mission Work?  Yes/NO.  How much time____Hrs.  Daily/Weekly/Monthly.      

 

Which work of the Mission you can best perform? (Tick)Administration & Accounting/Fund Raising/Public Relation & Education / Multimedia Publicity & Adaptation Campaign/ Statutory, Govt. & Corporate House  Liaison/ Street Dog Care in your locality/ Medical & Surgery/Food Management/Legal Aid/ Transport/ Construction Projects & Maintenance/ Web Design/

Any other work_____________________________________________________________________

 

Do you have any idea or suggestions, how the Mission should work? Please describe below:

 

 

 

 

 

 

 

 

 

I am joining the Mission Saromayo to remove all street dogs from our city and to find accommodation for them.  I do believe that they are also creatures of God and therefore deserves our care to give them a better life. I solemnly pledge to do my best to achieve the

Mission goal to help our society as well as street dogs and be proud to live in a street dog free city.   I have gone through the Rules and Regulations of the Mission Saromayo and agree to abide by the same.

 

I hereby donate a sum of Rs. 100 (One Hundred Only) as my contribution for Membership.

 

 

  Date:                                                          Signature.               

                                                                     Signature of Parents(for minors).

                                                

 

 

                                                          REVERSE:

                            

                                                    (for Official Use Only)

 

 

Application Received  by: Sig/ Name/Date____________________________________________

 

Membership Introduced  by: 1. _______________________________  2. ______________________

                                                   Sig /Name                                                   Sig/Name

 

Membership Registered By.                                                  Regn: No.  0000  00  00  00                                            

                                                  Sig/Name                                                     Sl   Yr MM DD

 

 

Membership Donation Received By Sig/Name/Date:______________________________________

 

 

 

Receipt No:                               Date;

 

 

Entered in the  computer system by.Sig/Name/Date.______________________________________                            

 

 

Membership Badge & Rules Issued  by. Sig/Name/Date. ___________________________________

 

 

 

Remarks.

 

 

 

 

 

 

 

 

 

 

Approved :     President/ Vice President/ Secretary.