GULMI ZILLA SAMAJ UK
MEMBERSHIP APPLICATION FORM

Surname: .................... Forename:................

UK Address:................. Home Tel:................

............................ Mobile:..................

............................ Email:...................

Postcode:...................

Nepal Address:
Pahad:……………………………....................................................................................
Town/Sahar (if applicable):…………………………......................................................


Signature:…………………………….. Date:……………………………
Lifetime Member £500.00 or Annual Member Fee of £10.00 to be paid by 30 April every year. Paid by Cash or Cheque.

On receipt, a membership card will be forwarded in a holder but email a photo for card to Coordinator or Secretary.
Annual membership booklet, accounts and annual function forecast will be forwarded.
Email Coordinator: Om_thapakaucha@hotmail.co.uk or Secretary: Toybdr53@msn.com
Completed Application to: Mr Om Thapa, 14 Homelea Close, Farnborough GU14 8HH