presidency old students association (posa) · payment details for life membership: to, the...
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Email Id. : [email protected] : www.presidencyalumni.org
Address : CA - 4, H.M.T. Layout, R.T. Nagar, Bangalore - 560 032.
Phone : 98863 7462298450 94444 / 98452 09152
Application Form for Life Membership
“The Association under the name and style of “POSA” – “Presidency Old Students Association” is established with the sole motto to unite the past students of the Presidency schools and Presidency College in the closest bond of good fellowship and fraternity among the alumni and through that process assists the members of the Alumni and the Alma mater to achieve academic and professional excellence. It shall strive to be an umbilical cord between the Alumni, the Presidency Schools, Presidency College, the Management and Faculty”.
Paste your recent
Passport Size Photograph
Please choose the Presidency Institution that you Studied / Graduated:
1. Nandini Layout (Tick Mark)
2. R.T. Nagar (Tick Mark)
3. J.P. Nagar
(Tick Mark)St. Paul's English School
4. College-Hebbal
(Tick Mark)
5. Mangalore (Tick Mark)
6. Bilekahalli (Tick Mark)
7. Kasthuri Nagar (Tick Mark)
8. Yelahanka (Tick Mark)Kempapura
Off Bannerghatta Road
Personal Details (Mandatory):
Full Name:_____________________________________Nick Name : ______________________
Batch (Year of Passing 10th Std./College):_____________Studied upto Class:__________
Date of Birth: ____________________Date of Wedding Anniversary:__________________
Education Qualification:___________________________________________________________
Address for Correspondence:
Permanent: ________________________________
__________________________________________
__________________________________________
__________________________________________
Current: ___________________________________
__________________________________________
__________________________________________
__________________________________________
Landline No. : _______________________________
Mobile No. : _______________________________
Alt. No. (Parents / Siblings) : _____________________________________________________________
Mobile No : _______________________________
Alt. No : _______________________________
Present Occupation:____________________________________________________________________
Office Address:_________________________________________________________________________
_____________________________________________________________________________________
Telephone (Office):________________________Email Id.:_____________________________________
Occupational Details (Optional):
Email Id's : ______________________________________________________________________________
(Estd.1976)
(Estd.1980)
(Estd.1983)
(Estd.2000)
(Estd.2001)
(Estd.2006)
(Estd.2008)
(Estd.2012)
PRESIDENCY OLD STUDENTS ASSOCIATION (POSA)(ALUMNI OF PRESIDENCY GROUP OF INSTITUTIONS)
R
Note : Details to be filled in Block Letters Only.
Let us know in what way you could contribute:
Towards the development of the Institution and Your Juniors:
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
Towards the development of Alumni and Society at large:
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
Do you have an idea for our Alumni Meet Function - Pattern of programs, which you think
would help put up a good show - If yes, please share it with us:
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
Let us know, what you expect from POSA:
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
Share any suggestions, which you might have:
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
If you have information about your siblings and batch mates (Juniors/Seniors) passed out
from Presidency Schools/Presidency College, then share it with us to enable us to get in
touch with them:
Sl.No. NameSiblings /Cousins /
Batch mates
Batch(Year of Passing)
Contact No. and
Email Id.
1
2
3
4
5
Payment Details for Life Membership:
To,
The Secretary,"Presidency Old Students Association (POSA)",CA - 4, H.M.T. Layout, R.T. Nagar,Bangalore – 560 032.
Please enroll me as Life Member of the “Presidency Old Students Association” (POSA).
Subscription for Life Membership is being given herewith by:
Life Membership Amount Details:
Registration
Life Membership Contribution
Total Amount
: Rs. 50/-
: Rs. 1,950/-
: Rs. 2,000/-
Declaration:
I, .........................................hereby declare that the details given above are true
to the best of my knowledge and belief. I assure that I will agree to abide by the
Constitution rules and regulations of “Presidency Old Students Association” (POSA)
which are in force at present and amended from time to time. I also assure that I will
keep the office informed about the changes in my Address/Phone Number/Email ID/status,
if any.
Date:_____________ Place: _____________
_____________(Signature)
Cash Cheque DD
Details:...............................................................................
(Tick Mark) (Tick Mark) (Tick Mark)
Signature
Note: Please Mail us the payment details ( UTR / NEFT / DD / CHEQUE / Cash deposits )
Note: Before submitting the form kindly check whether you have given all the information correctly. If there is any change of address and Phone Number in future, kindly inform us by email. The changes will be added in the Alumni Directory.
Submission Procedure :
1. Either scan and e-mail your completed form with a identification of your Address Proof Xerox copy to: [email protected]
Or
Account Name : “Presidency Old Students Association” (POSA). Current Account No. : 32703156215IFSC Code : SBIN0007982Bank Name : State Bank of India, R.T. Nagar, BangaloreLandmark : Opposite R. T. Nagar Post Office / Above Food World
2. Post your completed form with a identification to:
The Secretary,“Presidency Old Students Association” (POSA), CA - 4, H.M.T. Layout, R.T. Nagar,Bangalore – 560 032.
For further details, please contact the Secretary of POSA.
For Office Use:
Name of the Alumnus:................................................................................
Membership ID No.:.....................Batch:.............Date:.................................
Cash / DD / Cheque No................................ Date.................................
Bank................................ Receipt No....................Date:................................
Remarks:
Verified the above details: Signature of the Secretary
POSA Bank Details: