|
| 1. Name |
|
| 2. Date of Birth |
( Date / Month / Year ) |
| 3a. Resident Address |
|
| 3b. Office Address |
|
| 4. Contact
Numbers |
|
| 5. May be contacted
thru |
|
| 6. Details of academic tenure at St.
Vincent's |
|
|
| |
| Major Achievements at St.
Vincent's |
|
Scholastic |
|
|
Sports/Athletic |
|
|
Other |
|
|
Left St. Vincent's because |
|
| |
| 7. Please indicate, for elections,
your single choice of year of passing St. Vincent's whether
actual or notional ( i.e. year you would have passed out, if
you had continued at St. Vincent) (If not clearly indicated, the
membership Sub-Committee of the Executive Committee shall
determine the year of passing.) |
| |
| 8. Details of Education ( from High
School onwards): |
|
|
| |
| 9. Details of Service / Employment /
Occupation / Profession / Business / Vocation
: |
|
|
| |
| 10. Family Information : (a)
(b) No. of
children |
| |
| 11. Suggestions / Interests
vis-à-vis VOBA (briefly) |
|
| |
I, hereby apply for Patron / Life
membership (click here) and
send
(in words, ) as fee by ,
Cheque
No. dated drawn on
Drawn on bank
I declare that I am applying for
membership and paying the requisite fees for the same,
voluntarily.
Further of the Life
Membership fees 80% is towards the corpus and 20% towards the
general revenue of the Association. The patron membership fees
are entirely towards the corpus of the Association.
I
agree, if admitted as Patron/Life member, to promote the
object of the Association, and to be governed by its
constitution and Regulation in force, as long as I remain a
member.
|
| |
| |
|
