Application form for membership in BBN
To
The president/secretary
Subject: Application for admission as a ordinary/Lifetime/ patronage/
associate member of the BBN
Dear Sir,
I wish to apply for admission as a member of above my particular are as under:
Sr. Subject Particulars
No.
1 Name of the applicant
2 Father’s/husband name
3 Permanent address:
4 Correspondence address
5 Date of birth
6 Occupation:
7 Phone no. with code
8
Email id
9
Pan no.(attach self attested copy ,if available)
10
Caste certificate
2. I certify that:
I. I unconditionally subscribe to the aims & objectives of the BBN and contribute towards
Attainment of the same.
II. I will abide by the Byelaws of the BBN, as applicable and amended from time to time
III. I have not been convicted of an offence involving moral turpitude involving imprisonment.
3. I am enclosing herewith the following documents.
I. Copy of ____________________________________________towards proof of Identity
II. Copy of ____________________________________________towards proof of Address
III. Copy of ____________________________________________towards proof of date of birth
IV. Copy of caste certificate
V. DD/pay order/cheque no. _______________dated ________________for Rs ____________drawn
in favour of towards one time membership fee.
VI. DD/pay order/cheque no. _______________dated ________________for Rs ____________drawn
in favour of towards Membership annual subscription for the year___________________
VII. Two passport size and one stamp size photographs:
I request you to kindly admit me as a ordinary/life time /patronage / associate member of the society
Thank you
Dated ________________________ yours faithfully
Place ________________________ (signature of the applicant)
Recommendation of a member of the BBN as per bye laws
I recommend admission of sh. _______________________ s/o_____________________________ aged
_________________years R/o _ _______________as ordinary/ life member of the society.
Signature of the Member
Name of the member
Membership no.
Date
place
Decision of the Chairman/ President:
Sh .______________________________S/o ________________________aged ________________Years
R/o_______________________________________ is admitted / rejected as ordinary/ life/ associated member of the
BBN w.e.fDt._____________under membership no. _____ ____________in the meeting of the Executive Committee held
on dt. ______
He may be issued an identity card of the society & his/ her name may be entered in the Books as a
Member accordingly
Dated: ____________________
Chairman/President
Place: ____________________