APPLICATION FORM FOR MEMBERSHIP
Name *
Father/Husband *
Emp No *
Dept *
Residential Address *
Permanent Address *
Mobile *
Date of Birth *
Age *
Bank A/c No *
PAN *
Aadhaar *
Cheque No *
Admission Fee
Share Money
Compulsory Deposit
Total
Nominee Details *
I declare that:
1. I am not a member of any other co-operative society dispensing credit.
2. I have never been declared as an insolvent.
3. I am an employee of Holy Family Hospital.
Rules & Regulations:
1. All transaction will be made through Cheques only.
2. Changes in details must be informed in writing.
3. Loans as per society rules.
4. Surety responsible for repayment.
5. Loans only for permanent employees.
Signature of Applicant: ___________________________
FOR OFFICE USE ONLY
Application considered on: ____________________
President Secretary Treasurer
Upload Photo *
Submit Application