CHANDIGARH MIZO UNION

Ka Ram leh Hnam tan

2012-2013 SESSION MEMBERSHIP FORM

Hming

: _____________________________________

Pa Hming

: _____________________________________

Nu Hming

: _____________________________________

Zirlai/Hnathawh

: _____________________________________

Institution/Dept.

: _____________________________________

Permanent Address

: _____________________________________

City/Town

: ___________________ State _____________

PIN Code

: ___________________Phone no (home) ___________

Local Address

: ______________________________
_____________________________

Phone No(Mob.)

: ____________________________

2012-2013 Session chhunga Chandigarh Mizo Union in dan a siam leh tih tur te zawm turin Cmu
member atan ka inpe e.
Date _________

Signature:
Hming: _____________________

CHANDIGARH MIZO UNION