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Membership Form
Membership Form
No:SOR/BLU/DR/25909-10
No.167, 36th Cross, 18th Main,4th 'T'Block,Jayanagar, Bangalore -560041 Ph: 8123546739
E-Mail : aruveluniyogiesangha@gmail.com website- www.aruvelu.org
No:__________
Date:__________
1.Name:_________________________________________________________________________________________________
2.Date of Birth (dd/mm/yyyy)_____________ 3.Gothram:________________________3a.Nakshatram____________________
4.Father/Husbands Name:__________________________________________________________________________________
5.Permanent Address:______________________________________________________________________________________
________________________________________________________________________________________________________
6.Present Address:_________________________________________________________________________________________
________________________________________________________________________________________________________
7.Mobile no:______________________________________ 8. E-mail id:_____________________________________________
9.Occupation:_____________________________________ 10.Blood Group:__________________________________________
11.No. of Members in your family:_____________________12.Your talents you wish to contribute:_______________________
Patronship Details:
Patron(Rs.10,000)_____ Vice Patron(Rs.5,000)_________ Life Member(Rs.1,000)_____ Yearly Member(Rs.100)____________
Introduced by:________________________________________________ Membership no:______________
I abide by the rules of Aruvelu Niyogi Bramhana Sangha and have paid the following towards Membership
Rs.________ Cash/Cheque/DD NO.__________ on____________________ dt__________
__________________________
Signature
Book No:
Date___________________________
General Seretary/President