26 Oct 2008 - Membership Form

 

OMAT ( Mauritius ) Ltd  

R Cassim Street , Curepipe Road , Mauritius

 

 

 

 

 

 

 

 

 

Membership Application  Form

 

 

 

 

 

 

 

Name: ……………………………Forenames…………………………….

 

Date of Birth: …………………...Place of Birth..…………………..........

 

Address:..………………………………………………...............................

 

               …………………………………………………….......................... 

  

Country…………………………Postcode…………………………………

 

 

 

 

            

Phone No: ……………………………… e-mail….....................................

 

How did you hear about the organization? ……………………………....

 

I agree to abide by the constitution of OMAT ( Mauritius ) Limited, to 

help in furthering the empowerment of the community that it serves, and to pay the annual membership fee due of Rs300.00.                     

Family membership Rs500.00

 

 

Signature:…………………………………… Date: ……………………….

 

 

 

 

 

  

  

For office use

 

Approved  on: …………………………………………………..

 

  

                                 Signature of the Chairman:………………………………………

                                             

 

                                                                             Company Limited by Guarantee

                                                                             Registered No: 57999