9/9/2014 : MEMBERSHIP FORM
MEMBERSHIP FORM
NATIONAL ASSOCIATION FOTR THE BLIND, CHANDIGARH STATE BRANCH
NAME: ____________________________________________________________
FATHER’S NAME _________________________________________________
ADDRESS _________________________________________________________
____________________________________________________________________
TEL NO. ___________________________________________________________
AGE/ DATE OF BIRTH ____________________________________________
SEX _______________________________________________________________
MARITAL STATUS _________________________________________________
NATURE OF BLINDNESS ___________________________________________
VOCATION _________________________________________________________
OCCUPATION ______________________________________________________
ASSISTANCE/SUGESSIONS _______________________________________
____________________________________________________________________
____________________________________________________________________
DATE:_____________
SIGNATURE: _________________
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