|
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$ |