NEHRU INSTITUTE OF MOUNTAINEERING, UTTARKASHI 249193 UTTARAKHAND (Registered under the Societies Registration Act No.XXI of 1860) APPLICATION FOR MEMBERSHIP Iwish to become an OrdinaryiLife Member of the Nehru Institute of Mountaineering, Uttarkas! read the Memorandum of Association and rules of the Institute and, (to_be forwarded in duplicate along with two coples of personal Bio data d proposed and seconded by NIM members) Namen full : (in Block Capitals) Age Casey essecessseuesstemessnsnessnenessnenntnet Sotnes ntennsinneassnnessirnratnaeeates PermanentAddress 2 Postaladdress With email address Stateinwhichborn — : or domiciled Profession or : ‘occupation with details REECE CECE CPC ecco eee of present post. Bankers : = SESESESEEsssnsssvcnueesneseseseeeeseoeee Signature of the applicant. Date PROPOSED BY Name (Member, Nehru Inst tute of Mountaineering, Uttarkashi) SECONDED BY : Signature Name (Member, Nehru Ins‘ itute of Mountaineering, Uttarkashi) Date FOR OFFICE USE ONLY Remarks of the Principal, NIM... Date Signature Principal,NIM Admitted/Not admitted as Life/Ordinary member of the meeting of the Executive Counci Date Signature Joint Secretary, MOD & ‘Secretary, NIM (Delhi)