I, the undersigned Shri/Smt ........................................... (Full name of the
applicant), hereby apply for the membership of your society, I furnish below the
following particulars about me:-
1. Full name beginning with Surname
2. Address (Residential)
4. Address (Service/Business/Profession).
5. Age on date of application.
6. Class of membership applied for (associate, nominal, sympathiser or ordinary).
8. Amount of share money and entrance fee tendered with the application (cross cheque, pay order and Demand Draft).
9. Particulars of agricultural land/Non-agricultural
land held by family as owner or as tenant
(whatever it is applicable).
10. Particulars as to membership of other Cooperative
Society/Societies, if any, together
with information about outstanding dues or
overdues, if any, in the society/societies.
11. Date of making application to the society and
reason if any for not accepting the application
by the society if known.
12. I undertake to furnish any other information as
may be required under the bye-laws of the
I hereby state that I need the services of the society and further state that I
have made myself aware of the provision of the bye-laws of the society, and I agree
to be bound by them in all matters relating to my transactions with the society.