ࡱ> ;=:7 } bjbjUU 47|7|}l 2p p p p p p p p 6888888$  \p p p p p \p p qp p p 6p 6X:,rp d `lM j( r0 RrOLD BOYS ASSOCIATION LOYOLA SCHOOL SREEKARIYAM, TRIVANDRUM 695 017 (Affiliated to the Federation of Jesuit Alumni/ae Associations of India) APPLICATION FOR MEMBERSHIP/BIODATA FORM(Please use Block Letters) 1. Full Name:2. Exam passed from Loyola:3. Year of Passing4. Educational Qualification 5. Profession6. Date of Birth7. Present Employment & Designation:8. Name any two of your batchmates in Loyola I. II.9. Permanent Address: PINCODE11. Office Address: PINCODE10. Residence Phone:12. Office Phone:13. Pager:14. Mobile:15. Fax:16. E-Mail:17. Website:18. Blood Group & Type:19. Correspondence to Residence/Office? (Please tick)FAMILY PARTICULARSFamilyNameDate of BirthEducationProfessionBlood Group & TypeWifeChild 1Child 2Child 320. MEMBERSHIP FEE (Details given below)Admission Fee (Rs.50/100/500)* Life Membership (Rs.200/500/1000)* Donation TotalRs. Rs. Rs. I hereby agree to abide by the Rules and Regulations of the O.B.A. An amount of Rs(Rupeesonly) is enclosed by Cash/DD/Cheque No ..dt drawn on .. in favour of Old Boys Association, Loyola School, Trivandrum. Place: Date:Please send this form to: M Pradeep Kumar Secretary, LOBA Madhavamandiram, Ushus Nagar, Pangappara PO, Kariyavattom Trivandrum 695 581FOR OFFICE USE ONLYRecommended by Signature: Name: Batch:Membership Code: Membership Sl.No. Receipt No. Admitted on Recorded on*Admission Fee Rs.50 plus Life Membership Rs.200 for all applying for Membership within an year of passing out *Admission Fee Rs.100 plus Life Membership Rs.500 for all applying for Membership within 7 years of passing XIIth Standard or within 9 years of passing Xth Standard. *Admission Fee Rs.500 plus Life Membership Rs.1000 for all applying for Membership within an year of passing out. $F | } 56\]6OJQJ]^J5\ $F}ww$If $$Ifa$i$$IfTl   064 l` a$If$a$ } /0>Oyyyy$If$$Ifl4F6:F"  06    4 laOPuvpyyyyyy$If$$Ifl4Fq F"  1 06    4 layyyyyyyyyy$If$$Ifl4Fq 6F" 06    4 la  ,5$Ifl$$Ifl406F"064 la56BCDQRSxyyyyyy$If$$Ifl4Fq F"  1 06    4 laSTlH@BBB$If$$Iflֈq 6:F"% 064 laP2 ) $$Ifa$Y$$Ifl4F""064 la$Ifl$$Ifl406F"064 la?,$$Iflֈq 6:F"% 064 la $$Ifa$B8$$Iflֈq 6:F"% 064 la$IfB8$$Iflֈq 6:F"% 064 la$If !"B8$$Iflֈq 6:F"% 064 la$If"*+,-./0B $$Iflֈq 6:F"% 064 la$If0CYxys$If$$Ifl4Fq F"  1 06    4 la$If   3 P c w t $$Ifa$Y$$Ifl4F""064 la$If w x y $Ifn$$Ifl4L0q F"` 064 la ]  } jeee & F$$Ifl4\q 6F"  1 064 la/ =!"#$% i0@0 Normal_HmH sH tH 2`2 Heading 1$@&5\8`8 Heading 2$$@&a$5\<A@< Default Paragraph Font.>`. Title$a$ 5CJ\4J`4 Subtitle$a$ 5CJ\,B`, Body Text6]}'4*$F/0>OPuv ,56BCDQRSTl !"*+,-./0CYx3Pcwxy]000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000 0 0 0} O5S"0w }  } uw SYhj$&+,14>COx{||Zj33Roshen ChandranD:\Ashok\oba.docRoshen ChandranGC:\WINDOWS\Application Data\Microsoft\Word\AutoRecovery save of oba.asdRoshen ChandranGC:\WINDOWS\Application Data\Microsoft\Word\AutoRecovery save of oba.asdRoshen ChandranGC:\WINDOWS\Application Data\Microsoft\Word\AutoRecovery save of oba.asdWMI\(z5@vq^`OJPJQJ^Jo( ^`OJQJo(o pp^p`OJQJo( @ @ ^@ `OJQJo( ^`OJQJo(o ^`OJQJo( ^`OJQJo( ^`OJQJo(o PP^P`OJQJo(^`OJPJQJ^Jo( ^`OJQJo(o pp^p`OJQJo( @ @ ^@ `OJQJo( ^`OJQJo(o ^`OJQJo( ^`OJQJo( ^`OJQJo(o PP^P`OJQJo(WMI5@v                  0>OPuv ,56BCDQRSTl !"*+,-./0Ycwxy@||8d|]F"}p@UnknownG:Times New Roman5Symbol3& :Arial?5 :Courier New;Wingdings"1h14Dh4D13, !02QOLD BOYS ASSOCIATIONRoshen ChandranRoshen Chandran Oh+'0 ( D P \hpxOLD BOYS ASSOCIATION9LD Roshen ChandranoshoshNormalCRoshen Chandran49hMicrosoft Word 9.0O@@蹟@, ՜.+,0 hp  Blueshift, Inc.  OLD BOYS ASSOCIATION Title  !"#$%&'()+,-./013456789<Root Entry F V>1TableWordDocument4SummaryInformation(*DocumentSummaryInformation82CompObjjObjectPool V V  FMicrosoft Word Document MSWordDocWord.Document.89q