Past Student's Association (B.K.Model High School, Belgaum)

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Past Student's Association (B.K.Model High School, Belgaum) - Life Membership Form

Dear Past Student's of B.K.Model High School,

Please note that Life Membership Fee is Rs. 500/-

You can become a Life Member by paying the amount Rs. 500/- through Cash/Demand Draft/Cheque/Internet banking facility.

Cash - Directly pay at School
Cheque /Demand Draft : in favor of "Past Student's Association, B.K.Model High School, Belgaum" - should be sent to school address

For Online Money Transfer please note the following details

1. IDBI Bank, Belgaum
A/c. No : 555104000027089

2. State Bank of India - Belgaum Main Branch
A/c. No : 10911091434
Bank code : 816

Last Name *

First Name *

Middle Name *

Address for Correspondence *

Permanent Address *

Telephone Number / Mobile Number *

E-Mail ID *

Occupation *

Years of Study in School (From) *

Years of Study in School (To) *

Years of Passing (SSLC)

Life Membership Payment Mode (Rs.500/-) *

Donation Amount

(Optional)

Donation Payment Mode

Transaction Number/Cheque Number/DD Number (Write Cash if payment mode is cash) *

Please Suggest names and contact details of your classmates/senior/junior past students

One Per line(Name, Mobile Number/Email id)

Submit

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