MEMBERSHIP FORM

GOVT. REGD. NO. 5146/2006                                        ESTD. 20TH FEB 2005

BODHJUNG SCHOOL ALUMNI
BANAMALIPUR, AGARTALA, TRIPURA

FROM SL NO.                                                                   DATE                          


TO
THE GENERAL SECRETARY
BODHJUNG SCHOOL ALUMNI
AGARTALA

MEMBERSHIP REGISTRATION APPLICATION

DEAR SIR

I AM GLAD TO INFORM YOU THAT I ...................................... WISH TO BE A MEMBER OF THE BODHJUNG SCHOOL ALUMNI BEING EX-STUDENT OF BODHJUNG H. S. SCHOOL. NECESSARY PARTICULARS ARE FURNISHED BELOW:

1. NAME OF THE APPLICANT:

2. FATHER'S NAME:

3. PERMANENT ADDRESS:
(STATE TEL/MOB. NO./EMAIL ID)

4. PRESENT ADDRESS:

5. QUALIFICATION:

6. YEARS ATTACHED WITH SAID SCHOOL/ PASSOUT YEAR:

7. OCCUPATION:

8. REMARKS
(EXTRA CURRICULAR ACTIVITIES/
ANY OTHER POINT TO BE MENTIONED)

DECLARETION

I DO HEREBY DECLARE THAT I WILL ABIDE BY THE RULES AND REGULATIONS AS LAID DOWN IN THE CONSTITUTION AND ANY AMENDMENT THEREOF THE BODHJUNG SCHOOL ALUMNI AND WILL ACTIVELY WORK FOR THE CAUSE OF ALUMNI. I ALSO DECLARE THAT THE EC ALUMNI HAS THE RIGHT TO CANCEL (BY LAW PARA 18) MY MEMBERSHIP , IF ANY DIFFERENCES ARISE, THOUGH I AM AN EX STUDENT OF BODHJUNG HS SCHOOL.

SECONDED BY:                                          FULL SIGNATURE OF APPLICANT
(NAME AND SIGN)
MEMBERSHIP ID:                                      PAID RS.......................................ONLY

______________________________________________________________

OFFICE USE ONLY

GRANTED/CANCELLED

 INFORMATION

ALUMNUS OF BODHJUNG SCHOOL