DO NOT CHANGE SIZE
      WHILE COPYING OR
      PRINTING THIS FORM


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Seo2 india-devang barot - Indian Youth Congress Membership From

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Hi all Download this Membership form Devang Barot ( SEO2India ) 117 Loksabha - Kheda For more info visit : www.iyc.in check his national toll free u can call From any BSNL Landline

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Seo2 india-devang barot - Indian Youth Congress Membership From

  1. 1. DO NOT CHANGE SIZE WHILE COPYING OR PRINTING THIS FORM Membership Form Instructions : PHOTO 1) Form should be preferably filled in English and in BLOCK CAPITAL LETTERS only iyc1209 8.2 2) Attach photocopy of approved Address proof, Photo ID proof & Age proof Barcode 3) Remit Membership fee of Rs 15 or Rs 5 for Women and SC/ST (attach Paste recent photocopy of caste certificate). An additional surcharge of Rs 5 may original apply during the last 3 days of membership drives. photograph. Do not staple. State : Lok Sabha : Assembly : Panchayat/ Ward : First Name Last Name Full Name : Father/Husband’s Name : Strike out whichever is not applicable D D M M Y Y Y Y Date of birth : Sex : M F Blood group : Present Address : City/District : Pincode : Landline : Mobile : * Separate the STD code and number with a dash Profession : Category : General SC ST OBC Minority Email : Declaration : I wish to apply for the annual membership of the Indian Youth Congress. I accept the constitution of the Indian Youth Congress and I declare that - - The information given by me in this form and enclosures is true. - I am under 35 years of age and a Citizen of India. - I am not a member of any other political Party. - I have never been convicted of any criminal Signature / offences by any court Thumb impression : Date : * Ensure signature / thumb impression is within the box Acceptance of the membership form does not guarantee enrollment as a member of the Indian Youth Congress The membership fee paid along with the form is non-refundable under any circumstance Office Assembly code : Age Proof verified: Age Proof code : Date : use Panchayat /Ward Address Proof verified: Address Proof code : only : code : Received Rs. ________ LRO name : ___________________________ LRO signature : Receipt INDIAN YOUTH CONGRESS Barcode You must produce this #5 Raisina Road, New Delhi - 110001. receipt during voting Ensure that barcode sticker is pasted on the Name : receipt. Father / Husband Name : (Strike out whichever is not applicable) Received Rs.________ Assembly code : Panchayat / Pincode : *To be filled by LRO Ward code : towards subscription *To be filled by LRO Date : LRO name : LRO signature : Reach us: Web : www.iyc.in Email : support@iyc.in Helpdesk : 1860-425-4357 (Monday to Saturday, 10AM to 5PM) Acceptance of this form does not Find out more at www.iyc.in guarantee enrollment into the IYC The IYC is Transforming ! The membership fee is non-refundable under any Open Internal Code Professional Nationwide Performance circumstance Membership Elections of Conduct Training Programs Management

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