Membership Form

To

The President

Forum for Confederation in the Sub-Continent

A-45, IFS Apartments, Mayur Vihar-1

Delhi-110091

Dear Sir,

Please enroll me as a member .....................................(Category) of the Forum for Confederation in the Sub-Continent.
(Categories : Resident Life; Resident 5 years ; Non-Resident life ;Non-Resident  5years  Associate Resident ;  Associate Non-Resident.)

My Particulars are given below :

                    Name :................................................................                  Age : ...................    Sex (M/F).      

       Title (if any) ........................................................        

Profession :...........................................................................................................................................

Mailing Address :..................................................................................................................................

............................................................................................................................................................

............................................................................................................................................................

Tel:......................................................                      Fax :...................................................................

E-mail :................................................................................................................................................

Details of Cheque/Bank Draft/Cash :....................................................................................................

............................................................................................................................................................

Date :..............................                                                                                                                    

Place :.............................                                                                   Signature :.................................