Membership Application Form

Salutation *

Name *

Gender

Male Female

Membership Duration *

Date of Birth *

Email *

Contact No. *

Education Qualification *

Upload your ID proof* Upload ID proof
File size max 500 kb.

Personal Photo * Personal Photo
File size max 500 kb.

Address *

City *

Zip Code *

Name of Emergency Contact *

Emergency Contact No.*

Relationship to Emergency Contact *

Parent/Guardian Name *

Parent/Guardian Contact No. *

Language *

Hobbies *

Career Goal *

Reading Centre Reference *

I have read all the rules and regulations mentioned in the form description.

I agree to the terms and conditions and accept the responsibilities outlined therein. By acknowledging these terms, you commit to adhering to the rules and regulations set forth by the center management & admin.