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

APPLICATION FORM FOR HOSTEL ACCOMMODATION

Fix here your Passport size Photo


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

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

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

 Office/College Address ...........................................................................................................................................

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

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

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

 

Conditions: Hostel accommodation is open to any person of good character, who, regardless of Caste, colour and creed, according to the availability of the rooms.

 

I accept the terms & conditions of YMCA Kollam.
 

Introduced by

(Only Existing Members)

 

Signature

Name

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

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

 

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

...............................................
Date:

 

Signature of the Applicant

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

 

Admission Fee Rs. ........................................

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

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

 

Signature of the Secretary        

TYPES OF MEMBERSHIP MEMBERSHIP FEE APPLICATION FORM