Membership Application Form: Downloaded copy

Page 2 of 2
 
     
1.

NAME:

     
2.  

CATEGORY OF MEMBERSHIP APPLIED FOR:
(tick the appropriate box)

     
   
a. General Member
     
b. Associate  
     
3.  

DATE OF BIRTH:

     
4.  

CONTACTS:

     
   
i. Mobile No:  
ii   E-Mail:    
iii   RESIDENCE:    
        Address:
         
        Phone:
         
iv   OFFICE:    
        Address:
         
        Phone:
     
5.  

OCCUPATION:

     
6.  

DESIGNATION:

     
7.  

Have you received any formal training in Indian Music?
(tick the appropriate box)

     
   
Yes No
     
8.  

If yes (in answer to entry no.7), then what is your specialization?

 
Date: Signature of Applicant: ________________________
 
Place:
 

Signature of Guardian (in case of minor applicant): ________________________


FOR OFFICE USE ONLY

 
Name:
Membership No.:
Receipt No.:
     
Referred by: Approved by: