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The Maharashtra State Angling Association

Regd. Office: Club House, Saki Vihar Road, Powai, Mumbai-400 072.

Powai Lake- 8571780
Sec.Res- 6364270
Treasurer Res- 6504152/3081638

Please enroll me as LIFE/ORDINARY/VISITING/TEMPORARY member of THE MAHARASHTRA STATE ANGLING ASSOCIATION. I enclose Cash/Cheque for Rs._______ being the prescribed entrance fee. I agree to abide by the Rules & Regulation of the Association, the following are my particulars-

1.        Applicant's Name ___________________________________________________________
                                                surname                                name                                 fathers name

2.        Profession/Occupation/Business _______________________________________________________
         (if in service, please state position held & particulars of the employers)
         (if in business, state full particulars)

3.        Married or Single _____________________

     a.    Name of Spouse ______________________
     b.    Name & Particulars of Children
                               Name                                 Male/Female                       Date of Birth

4.        Office Address ________________________________ (Tel Nos.) _______________________

           Residential Address ___________________________ (Tel Nos.) _______________________

5.        Membership of other clubs:

     a.    In India _______________________________________________

     b.    Outside India ___________________________________________

     c.    Whether applicant ceases to be a member of any club and the reasons
            therefor _______________________________________

6.        Previous experience in Angling _______________________________

7.        Any other information _______________________________________

8.        Length of time known to
            (i) the proposer ________________years;             (ii) the seconder _______________ years
            I declare the statements made by me in this application are true.

Dated this                 day of                       19      .

                                                                                                Signature __________________________

We the undersigned, personally know the applicant and to the best of our knowledge the particulars given by him in this application form are correct. In our opinion, the applicant is a fit person for enrolment as a member of the Association. We accordingly recommend this application.
PROPOSER ______________________ No._________ Signature _______________

SECONDER ______________________ No._________ Signature _______________

Dated this                 day of                       19      .

(For the Executive Committee)

Received Rs. ___________ (Cash/Cheque) on ____________
                                                                                                                HON. TREASURER

Elected as a _____________________ Member on ______________________

Date ___________                                                                 HON. SECRETARY                 CHAIRMAN