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MEMBERSHIP APPLICATION FORM Name : ____________________________________________________________________________ Surname Middle Name First Name. Occupation:________________ Age (if below 18
years) Name of Father/Mother(for
Minors).______________________________ Occupation____________ Postal Addresss: ___________________________________________________________________ Telephone Nos:_____________________________E.Mail
Address:_________________________ Possession of Dog/s _____No/s.
Pedigreed_____ No/s
Indian____No/s.
Ages_______________ Time Donation for the Which work of the Any other work_____________________________________________________________________ Do you have any idea or suggestions, how the I am joining the 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. |