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To
The General Secretary,
Refugee Relief & Rehabilitation Officers' Association
Regd. No.- S/80747 of 1995-96
Industry House (3rd. & 4th. Floor)
10, Abanindra Nath Tagore Sarani, Kolkata – 700 017.
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I, Sri / Smt.
Rehabilitation Officer Sub-Divisional Relief & Rehabilitation Officer District Rehabilitation Officer , now
posted at
Earnestly willing to become
a member of Refugee Relief & Rehabilitation Officers' Association (RROA) on and from
/
/
My particulars are given below for your record and I am also submitting entry fee of Rs. 50/- only with this application and relevant proforma declaration for kind acceptance of the same from your end.
Thanking you,
Yours sincerely,
(Sign. of the applicant)
My particulars:-
1. Name
:
2. Father / Husband's name
:
3. Permanent Address
:
4. Present Address
:
5. Office Address
:
6. Contact No.
:
(Mobile)
(Residence)
7. E-mail I.D.
:
8. Date of Birth
:
/
/
9. Date of Joining in the present post
:
/
/
10. Date of Joining in the Service
:
/
/
11. Academic Qualification
:
12. Proficiency in other field
:
DECLARATION
I, Sri / Smt.
son/daughter/wife of
Posted as
Declare as follows:-
(1) I am not a member of any other employees’ organisation at present.
(2) I will remain ever to abide by the rules & regulations of the constitution of our association after acquiring my membership.
(3) I will pay my subscription regularly and any other contribution as a member as stipulated by the RROA.
(4) I will remain to obey the decisions taken by the Executive Body of RROA in any issue.
(5) I shall not be a member of any other organisation of employees during my membership in RROA.
(6) I will submit an intimation at least 3(three) months before withdrawn my membership from RROA after clearing all of my dues related to my membership.
(Signature of the Declarant)

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Secretary RROA

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