The Maharashtra State Angling Association
Regd. Office: Club House, Saki Vihar Road, Powai, Mumbai-400 072.
Powai Lake- 8571780
Sec.Res- 6364270
Treasurer Res- 6504152/3081638
APPLICATION FOR MEMBERSHIP
Please enroll me as LIFE/ORDINARY/VISITING/TEMPORARY member of THE MAHARASHTRA STATE ANGLING
ASSOCIATION. I enclose Cash/Cheque for Rs._______ being the prescribed entrance fee.
I agree to abide by the Rules & Regulation of the Association, the following are my
particulars-
1.
Applicant's Name ___________________________________________________________
surname
name
fathers name
2.
Profession/Occupation/Business _______________________________________________________
(if in service, please state position held & particulars of the employers)
(if in business, state full particulars)
3.
Married or Single _____________________
a.
Name of Spouse ______________________
b.
Name & Particulars of Children
Name
Male/Female
Date of Birth
4.
Office Address ________________________________
(Tel Nos.) _______________________
Residential Address ___________________________
(Tel Nos.) _______________________
5.
Membership of other clubs:
a.
In India _______________________________________________
b.
Outside India ___________________________________________
c.
Whether applicant ceases to be a member of any club and the reasons
therefor _______________________________________
6.
Previous experience in Angling _______________________________
7.
Any other information _______________________________________
8.
Length of time known to
(i) the proposer ________________years;
(ii) the seconder _______________ years
I declare the statements made by me in this application are true.
MUMBAI
Dated this
day of
19
.
Signature __________________________
DECLARATION BY PROPOSER AND SECONDER
We the undersigned, personally know the applicant and to the best of our knowledge the
particulars given by him in this application form are correct. In our opinion, the
applicant is a fit person for enrolment as a member of the Association. We accordingly
recommend this application.
PROPOSER ______________________ No._________ Signature _______________
SECONDER ______________________ No._________ Signature _______________
Mumbai
Dated this
day of
19
.
(For the Executive Committee)
Received Rs. ___________ (Cash/Cheque) on ____________
HON. TREASURER
Elected as a _____________________ Member on ______________________
Date ___________
HON. SECRETARY
CHAIRMAN