DTEA R.K.

PURAM SCHOOL ALUMNI SOCIETY R1, Park View Apartments, Hauz Khas Enclave, New Delhi 110 016. APPLICATION FORM FOR MEMBERSHIP
1. Name of the Candidate 2. Date of Birth 4. Fathers Name 5. Mothers Name 6. Permanent Address : : : : 3. Sex:
Affix recent Photograph

Address for Correspondence

7. Class & Course studied : 8. Year of Completion : 9. Details of Qualification, Present Employment (if any) : 10. Reference from DTEA RKP Alumni : (1) Name Batch Signature (2) Name Batch Signature Declaration

I_________________________hereby declare that the details given above are true to the best of my knowledge and belief. I assure that I will abide by the rules and regulations of DTEA R.K Puram School Alumni Society which are in force at present and amended from time to time. Signature of the Applicant For Office Use Only Membership No._______ Annual /Life Membership Fee Rs. __________ Receipt No________ Date_________ Cash/DD/Cheque No_________ Date________ Bank__________________

Name and Signature of the Office Bearer (Change of Address/Status etc. to be recorded overleaf) **[MEMBERSHIP WILL BE CONFIRMED AFTER VERIFICATION OF THE NECESSARY DOCUMENTS] ----------------------------------------------------------------------------------------------------------RECEIPT Membership No._______ Annual /Life Membership Fee Rs. __________ Receipt No________ Date_________ Cash/DD/Cheque No_________ Date________ Bank__________________

LETTER OF INTENT I, _______________________________ resident of ____________, hereby agree to the Memorandum of Association & Rules and Regulations of the DTEA R.K. PURAM School Alumni Society, which will enrol me as a Member of the Society. 2. I, do hereby undertake that I have, correctly understood all the provisions contained in the

Memorandum of Association and Rules & Regulations of the DTEA R.K. PURAM School Alumni Society and agree to abide by the same. The terms and conditions as laid down in the Memorandum of Association and Rules & Regulations of the DTEA R.K. PURAM School Alumni Society for its Members will therefore, be binding on me. Failure on my part to adhere to the prescribed terms and conditions at any point of time may lead to forfeiture of my membership from the DTEA R.K. PURAM School Alumni Society. 3. I, do solemnly affirm that the documents and credentials, as required by the Memorandum

of Association and Rules & Regulations of the DTEA R.K. PURAM School Alumni Society, have been correctly furnished and all statements/facts contained therein are true to the best of my knowledge and understanding. Applicant__________________ Witness: 1._____________________ 2._____________________