Members


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Membership Form

Name of Applicant: Date of Birth/Age:
Name of Spouse: Date of Marriage:

Particulars Regarding Children and Other Dependent Members (staying along with)

Name: Relationship: Date of Birth/Age:
Name: Relationship: Date of Birth/Age:
Name: Relationship: Date of Birth/Age:
Name: Relationship: Date of Birth/Age:

Permanent House Address(Address In Native Place):

Local Address (Residential) :

Local Address (Optional) :

Telephone Number:

Mobile Number:

Email:

I hereby declare I will abide by the constitution of the Kutch Kerala Samajam, Gandhidham. I also declare that I am not/a member of any other Samajam/Welfare Association in Kutch District.

or you can download the Membership Form

Download Membership Form

 

For more details you may please contact

  • Secretary : Shri V. Devadasan – +91-9426253500
  • Treasurer: Shri Satish K. Nair – +91-9825226077