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Application form for members  
 

Please fill out the form and return it :
- by e-mail: avni@afindia.org

- to the center:
Alliance Française de Bombay
Theosophy Hall 40, New Marine Lines
Bombay 400 020
Tel: 2203 61 87 / 2203 59 93 Fax: 2206 61 57

Regd Public Trust No. E4283

Name Miss/Mrs./Mr.
 
Profession Student  
 
Date & Place of birth  
 
Residential Address  
 
Telephone Fax  
 
Office Address  
   
Telephone Fax  
     
  ( Please indicate where you wish to receive your magazine )  
E-mail  
 
Registered no.  
     
I hereby certify the accuracy of the above details and acknowledge the receipt of the rules and regulations of the Alliance françaises de Bombay.
     
     
Signature of member      
       
Signature of Director      
       
Proposed by two active members :    
  Name Signature  
1  
2  
       
Membership Fees     FULL YEAR
 
Entrance:
Single : Rs.100
Rs. 900
Couple : Rs. 200
Rs. 1700
Life Membership :
Rs.18000
 
   
Receipt No. Date Amount Valid until
 
 
     

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