Life Membership Registration Form
CUPA Admin Office
Kensington Apartments, Flat D, Ground Floor,
18/1 Ulsoor Main Road, Ulsoor,
Bangalore 560 008, Karnataka India
(Mon to Sat, 9.30 am to 5.30 pm)
Ph: 080 22947317
Full Name
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Age
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Permanent Address
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Areas of interest
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Telephone
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Mobile
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E-mail
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Occupation
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Children if any
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(The CUPA Board normally approves of ALL Life Memberships. Incase your request is not approved by the Board, your application amount will be returned.)
Declaration
On my being approved and accepted as a Life member of CUPA, I accept and will abide by the Policies and Regulations of the Organisation. I will at no point, go against the Organisation, singly or in concert with others at any time intended to deliberately bring down the efficiency & reputation of the Organisation, in public or otherwise.
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