AIDS MUKTI VAHNI SAINA TRUST
S.K BHATNAGAR
TRUSTEE
AIDS MUKTI VAHNI SAINA TRUST
216,
palika Bazar Kapoorthala Aliganj
LUCKNOW.9336142897
Dear
Sir,
We hereby apply as member OF AIDS MUKTI VAHNI SAINA TRUSTas per the following details:-
1. Name of the Organization: ___________________________________________
2. Address: __________________________________________________________
__________________________________________________________________
Tel. No.________________________ Fax No._________________________
Mobile No. __________________________________
E-mail___________________________________________________________
3. Status of the Organization (Society/Trust/25B Company) ___________________
4. Date of Registration: __________________Regn. No._____________________
5. Major Activities: ___________________________________________________
__________________________________________________________________
(Attach separate sheets, if necessary)
6. Geographical territories where major activities undertaken : _________________
__________________________________________________________________
7. Income & Expenditure during last financial year:
Income Rs._________ lakhs
Expenditure
Rs. ________ lakhs
8. No. of employees : Full time______ Part time ______ Volunteers _______
AIDS MUKTI VAHNI SAINA TRUST
9. Contact Person:
Name_____________________________________________________________
S/o, D/o, W/o _______ ________ ________ ______ ______ _____
_____ ____ __
Designation________________________________________________________
Address___________________________________________________________
__________________________________________________________________
Tel. Nos._____________________ Fax No.____________________________
E-mail: ____________________________________________________________
DECLARATION
We
hereby confirm that
i.
The information provided herein above is true and correct
to the best of my/our
knowledge and belief.
ii.
We undertake that we shall abide by the Rules and Regulations
of AIDS MUKTI VAHNI SAINA TRUST
iii.
Our organization is not black-listed by Government or any
other organization.
We
are aware that
AIDS MUKTI VAHNI SAINA TRUST is playing a role of ‘facilitator’ between us and funding organizations.
ii. AIDS MUKTI VAHNI SAINA TRUST do not promise or guarantee funding.
iii.
Application only does not entitle membership status to
us.
We
attach the following :-
i)
Self Certified copy of the Registration/Renewal Certificate.
ii)
Self Certified List of present Office Bearers
iii)
Curriculum Vitae of the Contact Person and the Passport
size photograph.
iv)
Certified copy of the audited accounts of the last 3 years.
v)
Demand Draft No. ___________ for Rs. 1500 in favour
of NGO WELFARE TRUST towards Registration Fee.
Place:
Signature ___________________
Date
:
Name _____________________
Seal of the Organization
