Young Librarian Association                              (Reg. No. 01/01/01/21553/10)       86, Sami Manzil, Near Masjid, ...
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Membership Form Of Patrone Members Of Yla

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Membership Form Of Patrone Members Of Yla

  1. 1. Young Librarian 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 Patron MemberDear Sir,I am in understanding with the intents of the Young Librarian Association (YLA), and I herebyapply for admission to Patron 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 faithfullyMembership fee : 5000.00 (Patron Member )Please find enclosed Cheque/DD No. ……………………………… Drawn on (Name of Bank)… … ………………………………………Dated ……………………… For Rs. ……………………………………..Favoring: Young Librarian Association, Bhopal Money ReceiptReceived sum of Rs. …… ………. on behalf of Young Librarian Association (YLA) towardsthe payment of Patron membership from Shri/ Mrs./Ms. …………………………………….. Signature

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