ESTD: 1910 APP. No. KAMMA VIDYARDHI SAHAYA SANGHAM (Regd. No. 14/1975) D.NO. 27-12-75, GANDIKOTA COMPLEX, PRAKASAMROAD, —_, GOVERNORPET, VIJAYAWADA - 520 002. © 2577608, BOYS HOSTEL : 2454240, LADIES : 2481844 sono oke obs To, The Secretary, Photo Kamma Vidhyardhi Sahaya Sangham Sey Vijayawada -2. Sir, Ihave completely read or caused to be read, translated and understood the bye-laws of the sangham and | hereby agree to be bound and abide all the rufes and regulations contained int he bye-laws and any amendments to be made there to. | will discharge all the duties if any entrusted to me by the management committee for and on behalf of our Kamma Vidhyardhi Sahaya Sangham. | am herewith remmiting the membership fee of Rs. 1,00,000/- / Rs. 50,000/- / Rs. 25,000/- by way DD / Cheque No Bank. vndated.... ss (Rupees oon) 10 join as a member under the inp liar Poshakulu / Raja Poshakulu / Jeevitha Sabhyulu in our Kamma Vidhyardhi Sahaya Sangham. My details are given below. Member Details : (in case of NRI members) | hereby appoint the folowing person as my proxy to act on my behalf and to recommend a student for a scholarship. Proxy Detai Name and address .. Proxy Signature PH. No Introducer Signature Member Signature. 5) (Name : ... (Nam"<== AMMA VIDYARDHI SAHAYA SANGHAM (Regd. No. 14/1975) +] D.No. 27-12-75, Gandikota Complex, Prakasam Road, VIJAYAWADA - 520 002. © 2877606, Boys Hostel : 2454240, Ladies : 2481844 No: 171 DETAILS OF MEMBER (FILLIN THE CAPITAL LETTERS) 4. NAME IN FULL . th a va 2. FATHER NAME 3. MOTHER NAME 4. GOTHRAM 5. DATE OF BIRTH i PLACE 6. FULLADDRESS 7. PRESENT ADDRESS 9. OCCUPATION 10. PROFILE (Name _ a d