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Membership Form Of Yla

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  • 1. Young Librarians Association (Reg. No. 01/01/01/21553/10) 86, Sami Manzil, Near Masjid, Haneef Colony, Berasia Road, Karond, Bhopal, (M. P.) Mob. 09827369345, Email: samimanzil1@gmail.com MEMBERSHIP FORM Dear Sir, I am in understanding with the intents of the Young Librarians Association (YLA), and I hereby apply for admission to Membership. Please accept my vital membership. Particulars for membership are furnished below: Name: (Surname first) : Fathers/Husband Name : Date of Birth : Academic Qualification ; Designation : Department : Institution/Organization : E-Mail /Mobile No. : Office Address : Home Address : Date ---------------------- Yours faithfully Life Membership : Individual : Rs. 1500.00 (Including a copy of the Annual Journal) Institutional : Rs. 5000.00 (Including a copy of the Annual Journal) Annual Membership : Individual : Rs. 400.00 (Including a copy of the Annual Journal) Institutional : Rs. 900.00 (Including a copy of the Annual Journal) Please find enclosed Cheque/DD No. ……………………………… Drawn on (Name of Bank)… … … ……………………………………Dated ……………………… For Rs. …………………………………….. Favoring: Young Librarians Association, Bhopal Money ReceiptReceived sum of Rs. ………………………… on behalf of Young Librarian Association(YLA) towards the payment of Annual/Life membership for the year…………………………….from Shri/ Mrs./Ms. …………………………………….. Signature

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