Application for Life Membership

Name (in block letters) Age and Date of Birth Permanent Address Temporary Address Official Address Telephone Nos. LLine Mobile E-mail ID Areas of interest ( give ‘tick’ mark) Arts  Literature  Science  Sports  Games  Teaching  Philanthropic activities  Social service  Educational activities Elaborate on the items chosen (details) Declaration I shall be pleased to become a Life Member of the Centre for Advanced Studies and Services (CASS) and to avail myself of as many opportunities as I possibly can to patronize its programmes and projects. Place : Date : Name : Signature :

Application for Associate Membership

Name (in block letters) Age and Date of Birth Permanent Address Temporary Address Official Address Telephone Nos. LLine Mobile E-mail ID Areas of interest ( give ‘tick’ mark) Arts  Literature  Science  Sports  Games  Teaching  Administration  Marketing  Public Relation Elaborate on the items chosen (details) Declaration I shall be pleased to become a Associate Member of the Centre for Advanced Studies and Services (CASS) and to avail myself of as many opportunities as I possibly can to patronize its programmes and projects. Place : Date : Name : Signature :

Application for Patron Membership

Name (in block letters) Age and Date of Birth Permanent Address Temporary Address Official Address Telephone Nos. LLine Mobile E-mail ID Areas of interest ( give ‘tick’ mark) Arts  Literature  Science  Sports  Games  Teaching  Philanthropic activities  Social service  Educational activities Elaborate on the items chosen (details) Declaration I shall be pleased to become a Patron Member of the Centre for Advanced Studies and Services (CASS) and to avail myself of as many opportunities as I possibly can to patronize its programmes and projects. Place : Date : Name : Signature :