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WILLINGDON CATHOLIC GYMKHANA MEMBER PROFILE NAME OF MEMBER MEMBERSHIP NO by d6p9V2

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									                             WILLINGDON CATHOLIC GYMKHANA


                                  MEMBER PROFILE
NAME OF MEMBER:________________________________


MEMBERSHIP NO:______________________                  EMAIL ID:____________________________________


PHONE:     RESD:_________________ OFFICE:_________________ CELLPHONE:_________________


ADDRESS: __________________________________________________________________________


___________________________________________________________________________________


___________________________________________________________________________________


If, at a later date, you change your residence or your family profile (marriage, birth, death) please let us

know immediately either by email or by letter, mentioning your name & membership number.


NAME OF SPOUSE: ____________________                        M’SHIP NO:___________________________


NAMES OF CHILDREN (below the age of 25)                      AGE:                   D.O. BIRTH:
(in capital letters):

_______________________________________                     ________                __ _________________


_______________________________________                     ________                __ _________________


_______________________________________                     ________                __ _________________


Please email this form, duly filled in, back to us.

Thank you very much,

For WCG

Sd/-

HON. GEN. SECRETARY

								
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