MEMBER FACT SHEET

Mr. K.P. Vijayamohan

Please enter the following information for updating the Member's Database
SURNAME
FIRST NAME
OTHER NAMES
TITLE
PROFESSION
DATE OF BIRTH
BLOOD GROUP
DATE OF JOINING
MEMBERSHIP CATEGORY
MEMBERSHIP NUMBER
ADDRESS (RESIDENTIAL)
ADDRESS (OFFICIAL)
TELEPHONE NUMBER
MOBILE NUMBER
FAX NUMBER
E-MAIL ID
NAME OF THE SPOUSE
NAMES AND DATES OF BIRTHS OF CHILDREN
NAMES OF THE PARENTS
NAMES OF CLOSE RELATIVES WHO ARE MEMBERS OF THE CLUB
YOUR PROFILE
OTHER INFORMATION, IF ANY

Information required to create a Database of all members and to print a new Members Directory. Required to be completed before 31st August, 2009.