indian social club registration form-31122013
DESCRIPTION
adaddddTRANSCRIPT
Indian Social Club, Sohar
APPLICATION FOR LIMITED ORDINARY MEMBERSHIP-2014
Visit us at www.iscsohar.com Name: ……………………………………………………... Date of Birth: …../…../………
Nationality: ……………… Mother Tongue: …………… Membership Type : Single / Family
Occupation / Designation: ……………………….………. Company's Name :……………………………….
Passport No: ……………………………………………… Passport Expiry Date: …../…../………
Resident Card No: ………………………………………... Resident Card Expiry: …../…../………
Permanent Address Present Address
In Case of Emergency:
Contact Person: ……………………………………….. …………………………………………………
Tel : …..………………………………………………… Tel : Oman ……………………………………
Blood Group: ……… Marital Status: …………………. Email: ……………………………………………
List of Dependents: (Children’s below 18 Years only) and Spouse
Name Relationship Age Sex
I hereby declare that the information given below is true.
Date : …../…../……… Signature: ……………………………………
Name Membership No. Signature
Proposed by Seconded by
As per article of association, ISC Sohar, Fee Structure: Cost of form RO 1.000, Admission Fee RO 2.000
Annual Membership: Single RO 7.000, Family RO 15.000.
Enclosures: Copies of Resident Card, Passport, Photographs (2 Nos.)
Contact Mr. M.K.Mahadevan : 95223134 (between 4:00-7:00 PM or Mr. Rajesh 99385148 between 8:00AM-1:00 PM, 05:00 PM-08:00 PM
Email: [email protected]
FOR ISC OFFICE USE No.: ………………………….....
Approved By : ………………………………………………………………………………………….............
Hon. General Secretary / Hon. Jt. General Secretary
Date : …../…../……… Period From: …../…../……… To: …../…../……… Status: …………………
Subscription recd. RO.:…………………………………………………… Receipt No. : ………………….
(PLEASE TEAR HERE)
INDIAN SOCIAL CLUB, SOHAR
Rial Omani: No. : ……………………. Date: …../…../………
Received with Thanks from …………………………………………………………………………………
The Sum of R.O. …………………………………………………. Cash / Cheque ……………………….
Being Subscription for Limited Ordinary Membership for Family / Single status for the year ………
Received by: Name: ……………………………………... Signature: …………………………………..
ISC
S/F
001
(JA
N-2
014
to
DE
C-2
01
4)