Take the print out of this Application Form and send the duly filled & signed Application to the Secretary
along with the DD for the full amount for the Application fee.

YOUNG MEN'S CHRISTIAN ASSOCIATION

KOLLAM-1

MEMBERSHIP APPLICATION FORM

 


Name (in Capital letters) ...........................................................................................................................................

 Residential Address  ................................................................................................................................................

 ............................................................................................. Pin ..............................  Phone...................................

 Office Address ........................................................................................................................................................

 ............................................................................................. Pin ..............................  Phone...................................

 Date of Birth ........................ Nationality .................................  Religion .................................................................

 

Conditions: Membership is open to any person of good character, who, regardless of Caste, colour and creed, desires to unite his efforts for the goal of the Association; the harmonious development of body, mind and spirit, and building a universal brotherhood.

 

I accept the above basis of membership

CHECK THE ITEMS THAT YOU HAVE INTEREST

 Religious Programmes

   Y's Men's Club  
 Educational Programmes    Student Work  
 Social Service    Sports & Games  
 Music    Socials  
 Dramatics    Picnic  
 Public Speaking    Camping  
 Counselling    Any other:  
 Developments & Extensions      

Introduced by

(Only Existing Members)

 

Signature

Name

1......................................................................

2......................................................................

 

...............................................

...............................................

Date:

 

Signature of the Applicant


(For Office purpose only)
Approved by the Board on ...............................................................

 

Membership Fee Rs. ....................................

Receipt No. ..................................................

Membership No. ..........................................

 

Signature of the Secretary        

TYPES OF MEMBERSHIP MEMBERSHIP FEE APPLICATION FORM