SANCHAR NIGAM EXECUTIVES' SSOCIATION(I)
ORISSA TELECOM CIRCLE

 

 

NAME OF BRANCH:__________________

1. NAME OF MEMBER :__________________________________
   
   
2. FATHER / HUSBAND NAME :___________________________________
   
   
3. DATE OF BIRTH ( DD / MM / YYYY ) : ___ / ___ / _______
   
   
4. STAFF NUMBER (ALL INDIA) :______________
   
   
5. POST HELD :___________________
   
   
6. PRESENT OFFICE & PHONE :_______________________________________________________
   
   
   
7. RESIDETIAL ADDRESS & PHONE: ________________________________________________________
   
   
   
8. DATE OF ENTRY IN THE DEPARTMENT ( DD / MM / YYYY ) : ___ / ___ / _______
   
   
9. DATE OF ENTRY IN PRESENT GRADE ( DD / MM / YYYY ) : ___ / ___ / ______
   
   
10. YEAR OF RECRUITMENT : ___________
    
    
11. EDUCATIONAL QUALIFICATION : ___________________________________
    
    

DECLARATION

I hereby enroll myself as a primary member of SNEA(I) and agree to abide by the constitution of SNEA(I) and also agree to deduct my monthly subscription of Rs.25/= (Rs. Twenty Five Only) from my salary or cash.

Date:                                                                                                                                                                         Signature of Member

Date:                                                                                                                                                 Signature of Branch /District Secretary