APPLICATION FORM FOR SSMP MEMBERSHIP

[ In addition to application form for mailing, online application form is also available. Click the link below, for further action ]

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MEMBERSHIP APPLICATION FORM

STHREE SHAKTHI MAHILA PRATHISHTANA TRUST (R),MYSORE

MIG-8, "Sree Ganesh", Third Stage, KHB Layout,

Kuvempunagar, MYSORE - 570 023, Karnataka,     India

MEMBERSHIP APPLICATION FORM

Membership No. Life Member - LM-

Patron Member-PM-

Donor Member-DM-

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1) Name (in full)

2) Address (in full)

3) Age and Date of Birth:

4) Phone No. Landline-

Mobile Number

5) Qualification

6) Profession

7) Hobbies/Interests

8) Activities

   Achievements

9) Languages known:

Read -

Write -

Mother Tongue

        Being interested in the activities of the Prathishtana, I wish to become a member (Life Member, Patron Member, Donor Member). I enclose herewith a Demand Draft for Rs.               towards LIFE/PATRON/DONOR Membership. I also enclose herewith two passport size photographs of mine, along with a copy of my full biodata.

Place:

Date:                                                              SIGNATURE

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     MEMBERSHIPS INVITED

        The President of Sthree Shakthi Mahila Prathishtana Trust (R), Mysore, invites willing and interested ladies (from 9 years to 90 years) to become its members and whole-heartedly participate in its programmes. There are three types of memberships open, as on now:

        (1) Life Members -                (Indian)         Rs. 350-00*

                                                         (Abroad )         $ 100-00*

        (2) Patron Members:            (Indian)          Rs. 3000-00*

                                                         (Abroad)           $ 200-00

        (3) Donor Members:              Anything above Rs. 10,000

                                                                                     $       500

        All payments are to be made by Crossed Demand Draft in favour of President, Sthree Shakthi Mahila Prathishtana, Mysore, and mailed to Sthree Shakthi S. Mangala Satyan, President, No. MIG-8, "Sree Ganesh", Third Stage, KHB Layout, Kuvempungar, Mysore - 570 023, India, by registered post/registered air mail.



                                                                              S. Mangala Satyan,

                                                                                      President

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NOTE: Ladies interested in becoming a member, in one of the above three categories, are requested to copy the above APPLICATION FORM and send by Registered Post to: Smt.S.Mangala Satyan, President, Sthree Shakthi Mahila Prathishtana, MIG-8, "Sree Ganesh", Third Stage, KHB Layout, Kuvempunagar, MYSORE -570 023, along with a DEMAND DRAFT for the amount prescribed a particular category. They may also indicate

their email address, if any, for easy correspondence.

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Alternatively, interested ladies may fill the below given ONLINE APPLICATION FORM, for submission. The membership fee, by Demand Draft, may be sent by Registered Post, to the above address.

For online registration for membership please click here

ONLINE MEMBERSHIP APPLICATION

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______ I LOOK FORWARD TO YOUR VISIT AGAIN AND SUPPORT: MANGALA SATYAN, KANNADA NOVELIST
Marquee Code Maker

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MEMBERSHIP APPLICATION FORM

STHREE SHAKTHI MAHILA PRATHISHTANA TRUST (R),MYSORE

MIG-8, "Sree Ganesh", Third Stage, KHB Layout,

Kuvempunagar, MYSORE - 570 023, Karnataka, India

MEMBERSHIP APPLICATION FORM

Membership No. Life Member - LM-

Patron Member-PM-

Donor Member-DM-

____________________________________________________________________

1) Name (in full)

2) Address (in full)

3) Age and Date of Birth:

4) Phone No. Landline-

Mobile Number

5) Qualification

6) Profession

7) Hobbies/Interests

8) Activities

Achievements

9) Languages known:

Read -

Write -

Mother Tongue

Place:

Date: SIGNATURE

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