HYDERABAD RACE CLUB

MALAKPET, HYDERABAD - 500 036

SL.No...................

PROPOSAL FOR MEMBERSHIP

Class of Membership CLUB / STAND

(Delete Which is not Applicable)

Candidtate’s Name in Full : ..............................................................................................................................

Father’s Name : .................................................................................................................................................

Date of Birth & Age : .........................................................................................................................................

Permanent Home Address & Tel. No : ............................................................................................................

Present Residential Address & Tel. No. : .......................................................................................................

Whether Married or Single : .............................................................................................................................

Whether the Candidate owns any

Race Horse / Broodmare : ......................................................YES / No........................................................

If Yes / Mention Details : ....................................................................................................................................

Profession / Occupation : .................................................................................................................................

If in Govt. Service
State or Central.State Rank &
Present Appointment / Designation : ...........................................................................................................
- If in Business or Service other
than Govt.Service : ....................................................................................................................

- Name of the Company or

Firm & Position in it: ..................................................................................................................

- If above are not applicable

state nature of occupation &
source of Income: ......................................................................................................................

Average Annual Income over the 3 Years:

a) Earned : ................................................................. b) Unearned : ...................................................

PAN NO. : ...........................................................................................................................................................

Banker’s Name & Address and Account No:..................................................................................................

..............................................................................................................................................................................

Are you a Member of any Other Clubs in India / ELSEWHERE : YES / NO

a) If Yes mention Name & Address of the Club/s : ..........................................................................................

..............................................................................................................................................................................
 DECLARATION
I ...........................................................................................S/o.....................................................................................

Resident of..........................................................................................................................do hereby declare that :-

i) I am not found guilty by a competent court of a Criminal Offence involving gross

misconduct or moral turpitude and conviction for such offence has become
final or

ii) I am nor found guilty of a fraudulent practice by the Board of any Turf Authority in
India or by any Turf Authority outside India with which, the Turf Authorities or
India are in reciprocal arrangement

Whether the Candidate was Black balled or

his name was withdrawn at any time : .......................................................................................................................

Whether the Candidate’s application for

Membership was rejectd by any other Club : ............................................................................................................

Any other information you would like to Provide : .....................................................................................................

Length of time known to Proposer : ...........................................................................................................................

Length of the time known to Seconder : .....................................................................................................................

I shall abide by the Rules & Regulations of the Club and laws laid down by the Companies
Act - 1956.

Date: ................................................ Signature of the Candidate..............................................................................

DECLARATION
We the undersigned recommend the applicant for Election as Club \ Stand Member of the Club
(Delete the word not applicable)

To the best of our knowledge the above particulars are correct. The applicant has attained the age of
18 years and is received in general society. He is personally well known to us and is in our opinion a fit person
to be elected as MEMBER of the CLUBv

Name : ..................................................................................................
CLUB MEMBER
Proposed by

Signature : ............................................................................................

Name : ..................................................................................................
Seconded by CLUB MEMBER

Signature : ............................................................................................

Place : ............................................................

Date : .............................................................