Membership
Form for The Durgapur St.Xavier’s School Alumni Association
(Regd
under W.B Act XXVI of 1961 vide No. S/1L/86140 of 2011-12)
Name:
_______________________________________________________Batch___________
Email:________________________________________________________________________
(Please provide a personal mail id and not an office mail id)
Contact no.:(M)__________________________(Landline
with STD code)_________________
Current Address:______________________________________________________________
______________________________________________________________________________
Permanent
Address: _____________________________________________________________
______________________________________________________________________________
Professional Info:
Organisation____________________________________________________
Stationed at ____________________________Designation_____________________________
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To
The
Secretary
The
Durgapur St.Xavier’s School Alumni Association
St.Xavier’s
School, Bidhannagar, P.O. A.B.L Township, Durgapur 713206
Dear
Sir,
Please enroll me as a Member of The
Durgapur St.Xavier’s School Alumni Association. The information I have provided
in the form above regarding myself is true to my knowledge and belief. I have
enclosed a cheque/demand draft of Rs3000/=[kindly
add Rs50/= for out station cheques] towards membership, payable to The Durgapur St.Xavier’s School Alumni
Association, bearing number_______________dated _________, drawn upon ___________
_____________________________________________________payable at Durgapur.
Thanking you,
Yours faithfully,
________________________________ Dated:___________________
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For
Office use only:
Date
received on: _________Received by: _______________Membership No.______________