Membership Form

OLD BOYS' ASSOCIATION (Regd.)

GOVT. CENTRAL TEXTILE INSTITUTE

KANPUR

MEMBERSHIP FORM

Name:

…………………………………………..

Father's Name:

…………………………………………..

Residential Address

 

Permanent:

……………………………………………

 

…………………………………………………………

 

Pin 

   Tel.No.

 

 

 

 

 

 

 

 

Present:

…………………………………………………………

 

…………………………………………………………

 

Pin 

Tel.No.

 

 

E-mail:

…………………………………………………………

Mill / Office Address with Designation:

……………………………………………...

                                        ……………………………………………………………………..

Year of Passing: Diploma/ Degree/ M.Tech / Ph.D. from G.C.T.I. Kanpur   …..…...

Amount of Subscription:  Rs. .................(Rs. ...........................................................)

Mode of Subscription: by Cash / Cheque / Demand Draft

(Note: Please release DD/Cheque in favour of ‘Old Boys’ Association’ payable at Kanpur)

Date: ...............

 

 

Place: …........ 

 

Signature of Member

Please mail this Form along with subscription to:

Sri R.K. Yadav, Hon. Secretary,  8B, Laxmi Rattan Cotton Mills, Officers Colony,  Kalpi Road, Kanpur-208012

Contact No.  0512-2231783, Mobile No. 9450129982          

Website: www.obagctiknp.com

E-mail: obagctikanpur@rediffmail.com

                                Note:           Membership Fee    Life              Rs.  1000/

                                                                          Patron         Rs.   2000/

                                                                                              Abroad              200$