MEMBERSHIP FORM OF INDOOR GYMNASIUM HALL, DEPARTMENT OF SPORTS

AND YOUTH AFFAIRS, GOVERNMENT OF SIKKIM, NAMCHI, SIKKIM

1. NAME IN FULL (Block letters):.................................................................................

2. FATHER’S NAME IN FULL (Block letters):.............................................................

3. CONTACT NO:...........................................................................................................

4. DATE OF BIRTH:......................................................................................................

5. PROFESSION OF APPLICANT:...........................................................................

6. SCHOOL/COLLEGE/OFFICE:.................................................................................

7. COMMUNICATION ADDRESS:...............................................................................

8. PERMANENT ADDRESS:.........................................................................................

Kindly submit either birth certificate, adharcard or voter card at the time of
this form.

Signature of the player

1. One time registration fees Rs. 1200/-

2. Monthly fees Rs. 200/-

3. One supporting documents Voter card, Birth Certificate,

Adhar Card, etc.

4. Passport size photo 01 No.