ITALIAN EMBASSY CULTURAL CENTRE
50-E, Chandragupta Marg , Chanakyapuri, New Delhi-110021
(Entry from Nyaya Marg)
Tel: 26871901; 26871903; 26871904, Fax: 26871902
Website: http://www.iicnewdelhi.esteri.it Email: email@example.com
APPLICATION FOR MEMBERSHIP
(Fill in block letters)
Name : ________________________
Surname : ________________________
Gender : ________________________
Present Occupation : ________________________
Residential / Mailing Address : ____________________________________________
Landline Telephone : __________________
Mobile Number : ________________
Email : ____________________________________________
I am interested in becoming a member because (other than the cafeteria) __________________
PLEASE READ CAREFULLY: (Signature of Applicant)
Identity Documents to be submitted personally with two recent colour photographs
between 10:00am and 05:00pm (Mon. to Fri.) at the Reception:
(For Indian/ Italian Nationals)
Photocopy of Passport/ Driving License/ Election Card/ Govt. Identity Card.
(Dependent spouses of Italian Nationals and diplomats)
Photocopy of Proof of Residence with validity/ Diplomatic Identity Card of spouse.
Facilities for Members:
Invitations to Cultural Activities such as weekly film shows, music programmes, exhibitions etc.
Reading room - viewing DVDs, browsing Internet, reading Magazines & Newspapers
Access to Library
Access to Cafeteria.
Please collect your Membership Card from the Reception Desk.