Seawoods Malayali Samajam
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RegNo.:F/12022/THANE Address : Shop No 13 ,Shree Radha Krishna CHS Ltd. Sector 42-A, Nerul Navi Mumbai
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Seawoods Malayali Samajam
RegNo.:F/12022/THANE
Address : Shop No 13 ,Shree Radha Krishna CHS Ltd. Sector 42-A, Nerul Navi Mumbai 4000706
Membership Application Form
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Ordinary (Membership Amount 110 Rs. Validity 3 Years)
Life (Membership Amount 510 Rs. Validity Life)
Patronship (Special Category)
Name
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Age
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Date of Birth
Present Residential Address
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Phone Number
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Permanent Residential Address (Native Place)
Phone Number
Occupation
Occupational Address
Phone Number
Blood group
Email Address
Proposed By Person
Address & Phone Number
Membership Number
I hereby certify that all the information given above are correct to the best of my knowledge and agree to abide by the memorandum of association and the rules and regulation of the association.
Place
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Date
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Remarks if any (Please mention the time of convenience and availabilty at your home and the contact number so that we can contact you personally)