GERRUOK, HERRUOK & LUORRUOK
Membership Welfare Form
1. Personal Details
Full Name
ID Card No.
Phone
Email
Current Residence
Home County
Home Village
2. Beneficiaries
| # | Full Name | ID Card No. | Gender | Relationship |
|---|
3. Nominees
| # | Full Name | ID Card No. | Contact Details | Relationship |
|---|
4. Declaration
I, , hereby declare that the information provided above is true and correct to the best of my knowledge. I further commit to abide by the rules and regulations governing the Welfare Association.
Name
Date
Applicant Signature
5. Recommender Details
Membership Number
Full Name
Date
Recommender Signature
6. For Official Use Only
| Role | Name | Signature & Date | Remarks |
|---|---|---|---|
Chairman |
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Secretary |
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Treasurer |
Membership Number Assigned
Date of Approval