Press Club of India

Membership form

PERSONAL DETAILS :

Name of the Applicant Mr/Mrs./Miss :

Father's/Mother's/Husband's Name :

Age & Date of Birth:

Tel./Mobile No.:

Complete Postal Address (with PIN Code) ;

Office / Work Place Address :

Residential Address :

Names of Family Members :

Qualification :

Educational Qualification :

Professional Degree / Diploma etc. (if any) :

Any other Qualification/ Specialization :

Experience (in years) in the field :

PROFESSIONAL DETAILS :

Organization :

(If a freelancer/Self employed etc)

: Designation :

Department :

Monthly Income :

Period of association with :

Present organization :

Name of organizations Served Previously :

Dated ………………….2013 Signature of Applicant

- Please attach your recent passport sized photograph along with this form.

- Filled-up application form should posted along with address proof on following address :

PRESS CLUB OF INDIA

#424, RANGPURI

NATIONAL HIGHWAY No.8, NEAR SHIV MURTI

NEW DELHI-110037

TEL NO.011-65196500

Criteria for membership

i) A working journalist, freelancer or part time journalist, book writer, columnist will be
eligible to be an annual member of the Club

ii) All new applications for membership shall be put up before Managing Committee for
consideration. However Chairperson may immediately approve such application(s) provided
such application(s) should be approved by Managing Committee later on in its next meeting.

Disciplinary action:

The Managing Committee shall take appropriate disciplinary action against any member/s
for bringing the Club into disrepute or for any act, including violence, misbehave which
endangers the harmony of the Club. Such disciplinary action may, as the case warrants,
consist of suspension for a specific period or expulsion for a specific period or debarring
membership permanently.

Dated ………………….2013 Signature of Applicant