Reg. No. 02499

SAUDAMINI SATTVAM WELFARE ASSOCIATION

G-601, Time Residency, Sector-63, Gurugram, Haryana-122101

Membership Application

To
The President / Secretary
Saudamini Sattvam Welfare Association
G-601, Time Residency, Sector-63,
Gurugram, Haryana-122101

Photograph *JPG / PNG · Max. 0.5 MB (512 KB)

Subject: Application for membership

Applicant Information
Sr. No.	Subject	Particulars
1	Name of the Applicant *
2	Gender of the Applicant *
3	Date of Birth *
4	Personal Email ID (other than of POWERGRID) *	Your login username is your mobile number or email name, without @domain or any +alias suffix.
5	Phone No. with Code *	Country code Select your country code, then enter your phone number without the country code.
6	Father’s/Husband’s Name *
7	Occupation *
8	PAN No. *
9	Relationship with POWERGRID’s Employee/Rtd. POWERGRID’s Employee *
10	Related POWERGRID’s Employee/Rtd. POWERGRID’s Employee Name & POWERGRID’s Employee No.	POWERGRID’s Employee namePOWERGRID’s Employee No.
11	Aadhaar No. *	Enter your 12-digit Aadhaar number.
Add co-applicant information (optional)
12	Name of the Co-Applicant
13	Gender of the Co-Applicant
14	Date of Birth of the Co-Applicant
15	Personal Email ID of the Co-Applicant
16	Father’s/Husband’s Name
17	Relationship with Applicant
18	Phone No. with Code of the Co-Applicant	Country code
19	Aadhaar No. of the Co-Applicant
Address Information
20	Permanent Address *	Flat / house number, building * Locality / street * Area / landmark (optional) City / district * Country * State / province * PIN / postal code *
21	Correspondence Address *	Correspondence address is the same as permanent address Flat / house number, building * Locality / street * Area / landmark (optional) City / district * Country * State / province * PIN / postal code *

2. I certify that:

I unconditionally subscribe to the aims and objects of the Society and contribute towards attainment of the same.
I will abide by the Byelaws of the Society, as applicable and amended from time to time.
I have not been convicted of an offence involving moral turpitude involving imprisonment.

3. I am enclosing herewith the following documents:

(i) Copy of towards proof of identity. *JPG/JPEG, PDF or PNG · Maximum 0.5 MB (512 KB)

(ii) Copy of towards proof of address. *JPG/JPEG, PDF or PNG · Maximum 0.5 MB (512 KB)

(iii) Copy of PAN Card towards proof of date of birth. *JPG/JPEG, PDF or PNG · Maximum 0.5 MB (512 KB)

Enclose PDF, JPG or PNG files, maximum 0.5 MB (512 KB) each. PAN copy must be self-attested.

4. I request you to kindly admit me as a member of the Society.

Thanking you,

Yours faithfully,

(Signature of the Applicant) *

Dated:

Place: *