No.

Date of Issue:………………

GREAT
TOMO
A
GT LOGO
Regd. No: xxxxxxx

Regd. Office:
Address
Contact No. Mail Id, Web

APPLICATION FOR MEMBERSHIP

AFFIX A RECENT
PASSPORT SIZE
PHOTOGRAPH HERE

Name ------------------------------------------------------------------------------------------------------------------
Membership No. ----------------------------------------------------------------------------------------------------
Address ---------------------------------------------------------------------------------------------------------------

Note:
1. Please fill up the application form neatly and carefully.
2. Along with the application form please attach the following documents:
I. Two Passport size Photographs, NIC Copy
II. Copy School Leaving Certificate
The applicant should produce the originals while submitting the application form for verification;
otherwise the application form will not be accepted.
3. The Membership Committee keeps the right to reject a membership, even though the formalities
have been completed while enrolling as a member of the Society.

To
The Secretary
I request you to enroll me as a member of the Great Tomorrow (A Group of Multi Professionals). I hereby
agree to abide the Rules and Regulations framed under the By-laws of the Society from time to time. I
request you to allot me and I hereby agree that I shall deposit the Entrance Fee and Annual Subscription Fee
.
My particulars are given below:

1. Full Name _____________________________________________________________________

2. Age (in years) __________________________ Date of Birth_____________________________
3. National Identity Card No.________________________________________________________
4. GCE(O/L)
School Attended__________________________________________________Year__________
5. GCE(A/L)
School Attended__________________________________________________Year__________
6. Highest Educational Qualification__________________________________________________
University / Institute Attended_______________________________________Year__________
7. Marital Status___________________________
8. Permanent Address
____________________________________________________________________________________
____________________________________________________________________________________
__________________________________________________________________
9. Present/ Correspondence Address
____________________________________________________________________________________
____________________________________________________________________________________
__________________________________________________________________
10. Mobile No._______________________________ E-mail________________________________
11. Employed in [Govt. Service/Semi-Govt./Public Ltd. /Pvt. Ltd.]
______________________________________________________________________________
12. Office in which employed with full address
____________________________________________________________________________________
________________________________________________________________________
13. Designation____________________________________________________________________

Yours faithfully
Signature __________________________________
Date __________________ Name __________________________________

DECLARATION
I, ________________________________________________hereby truthfully and faithfully declare that,
the details given by me are correct. If anything found wrong, the Membership Committee have the right to
take necessary action against me. I promise to give written information to the Society regarding any change
in address of my residence, place of work or change in my office/occupation in future.
Yours faithfully,
Signature __________________________________
Date __________________ Name ____________________________________

FOR OFFICE USE ONLY

Application Received on ___________________ by Post/Hand/Courier Receipt No. _____________

Name & Signature of Receiver with Date

DECLARATION BY MEMBER OF MEMBERSHIP COMMITTEE
We hereby declare that ___________________________________________________________ who has
signed on the document in 2 places in our presence is known to us personally and keeping in view of the
By-laws and Aims and Objectives of the Society, we are of the opinion that he is fit to
be________________ member of the Society. To the best of our knowledge the information furnished by
him is correct. We shall be responsible individually/collectively for the compliance with the Society.
1. Member’s Signature ___________________________
Full name ________________________________________________________________________
Address ________________________________________________________________________
2. Member’s Signature ___________________________
Full name ________________________________________________________________________
Address ________________________________________________________________________

DECLARATION BY CHAIRPERSON OF MEMBERSHIP COMMITTEE

I recommend ________________________________________________ for the membership with
the Society. I know personally the above applicant. I have seen the National Identity Card
(No._________________) and all other information furnished by him are verified by me.

Name and Signature of Chairperson

The applicant has submitted/ not submitted the necessary documents with application and found
complete/ incomplete and Recommend to Accept/Reject the Application.

Secretary

The Membership Committee in its meeting held on ______________ has unanimously / by

majority are in favour / not in favour of the application hence accepted / rejected the application.

President

As per the Minutes of Membership Committee Meeting dated ___________ the applicant is admitted as a
member of the Society.

MEMO
Payment Details
Receipt No: ________________ Amount ___________________ Date ___________________
Cheque No: ________________ Amount ___________________ Date ___________________

Remarks: