PRESIDENCY COLLEGE ALUMNI ASSOCIATION, CALCUTTA
PRESIDENCY COLLEGE, 86/1, COLLEGE STREET, KOLKATA - 700 073
PHONE : 2219 2391
(Registered under West Bengal Societies Registration Act, 1961) ENROLMENT FORM To
The Hony. Secretary
Presidency College Alumni Association
Kolkata.Dear Sir,
I request you to enrol me as a life member of your association. The Life Membership Fee of Rs. 1000/- * is sent herewith by Cheque / Cash.
Date ___________________ Name (in block letters) _________________________________________________________________________
Occupation / Designation _______________________________________________________________________ Address (Permanent) __________________________________________________________________________
Address (For communication) ____________________________________________________________________
Phone No. (O) _______________________ (R) ______________________ (Fax No.) _____________________
E-mail ID ___________________________________________________________________________________ Years (Calendar) at the College___________________________________ Subject ________________________ Payment to be made by A/c.Payee Cheque drawn in favour of "Presidency College Alumni Association, Calcutta".
* Fee for students passing out and enrolling within 1 year is Rs. 750/-
-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- (FOR OFFICR USE) Life Membership No. : L
Enrolled on : Hony. Secretary / Jt. Secretary received with thanks from Shri / Sm. _______________________________________________________________
Rs. ______________________ (Rupees ______________________________________________________ only)
by cheque (No.____________________ Date ____________________ Bank_______________________ ) / Cash as Life Membership fee for Presidency College Alumni Association Calcutta.
Date ___________________________ Collector ___________________________
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