Membership form for Organizations


 
Name of Organization
Address
Phone/Mobile no.
Fax No.
Email Address
Chief Executive's Name and Designation.
Core activities of the applicant organization
Select the type of Membership
( Non-government voluntary organizations and trusts)

Nomination of one representative in General Body of      BHAVANA - Fee Rs. 5,000/-
Nomination of two representatives in General Body of      BHAVANA - Fee Rs. 10,000/-
Nomination of three representatives in General Body of      BHAVANA - Fee Rs. 15,000/-
Nomination of four representatives in General Body of      BHAVANA - Fee Rs. 20,000/-
Nomination of five representatives in General Body of      BHAVANA - Fee Rs. 25,000/-

Government & Semi Government Organizations and      Commercial Establishments - Fee Rs. 25,000/-

Details of payment of membership fee:

Note : Outstation cheques are not accepted. However “At Par” cheques and outstation cheques  drawn on  places where branches of Axis Bank exist will be accepted.
Mode of payment:
Cash D.D. Cheque
Amount in figures: Rs.
D.D / Cheque no. & date

Name of Bank and its branch where drawn:

Name of Bank and its branch where payable