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: (Childrens below 18 Years only) and Spouse

Name

Relationship

I hereby declare that the information given below is true.

Date : ../../

Name

Age

Sex

Signature:

Membership No.

Signature

Proposed 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: isc.sohar@gmail.com

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: ..

ISCS/F001(JAN-2014 to DEC-2014)

Seconded by