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OLD
BOYS' ASSOCIATION (Regd.)
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GOVT.
CENTRAL TEXTILE INSTITUTE
KANPUR
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Name:
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Father's Name:
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…………………………………………..
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Residential
Address
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Permanent:
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……………………………………………
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…………………………………………………………
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Pin
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Tel.No.
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Present:
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…………………………………………………………
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…………………………………………………………
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Pin
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Tel.No.
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E-mail:
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…………………………………………………………
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Mill / Office
Address with Designation:
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……………………………………………...
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……………………………………………………………………..
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Year of Passing:
Diploma/ Degree/ M.Tech / Ph.D. from G.C.T.I. Kanpur
.......…..…...
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Amount of
Subscription: Rs.
.................(Rs.
...........................................................)
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Mode of
Subscription: by Cash / Cheque / Demand Draft
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Date: ...............
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Place:
…........
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Signature
of Member
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Please
mail this Form along with subscription to:
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Sri
R.K. Srivastava, Hon. Secretary, 3A, Laxmi Rattan Cotton Mills,
Officers Colony, Kalpi Road,
Kanpur-208012
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Contact
No. Tel. No. 0512-2242164 Mobile No. 9839118057
E-mail: obagctikanpur@rediffmail.com
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Note:
Membership Fee
Life
Rs. 500/
Patron Rs.
1000/
Abroad $
100 |