ROTARACT NIFT-TEA COLLEGE
(Spon: Rotary club of Tirupur North)
R.I. DIST-3202
MEMBERSHIP APPLICATION / RENEWAL FORM - 2019
Theme 2019
Reg. No. / Roll No. *
Your answer
Name *
Your answer
Gender *
Hostel / Day Scholar *
Class *
Your answer
Address *
Your answer
DOB *
MM
/
DD
/
YYYY
Student Mobile Number *
Your answer
Parent Mobile Number *
Your answer
EMail id *
Your answer
Blood Group
Your answer
Hobbies *
Your answer
Additional Skills *
Your answer
Area of Interest to Work *
Will you take part in 60% of club's social and service activities? *
Are you willing to pay membership and district dues *
Are you existing member or new *
Aadhar Number *
Your answer
I understand and accept the Principles of Rotaract as expressed in its purpose and objectives and I agree to comply with and be bound by the standard Rotaract Club constitution, Rotaract statement of Policy and Bylaws of the club. *
Required
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