Phone: 03592 (231984, 225320, 223321)(O)
Fax    : 03592 (224725)
SPASTIC SOCIETY OF SIKKIM

Regd. No. 951 (LR/’97)
Special Education and rehabilitation Centre,
Jeewan Theeng Marg, Development Area, Gangtok, East Sikkim –737101
MEMBERSHIP CARD
Sl. No. ___________________
Name :      _______________________________________________
Address :     ______________________________________________
Phone :     ________________________________________________

 

MEMBERSHIP CATEGORY
1. ANNUAL MEMBER
2. LIFE MEMBER
3. DONOR MEMBER
4. CORPORATE MEMBER
_____________________
 Signature of Member/Donor
 ________________
_______________
Signature of General Secretary
Signature of President

 

SUBSCRIPTION AMOUNT
ANNUAL:
Rs. 200 p.a
LIFE MEMBER:
Rs 1000(One time)
DONOR MEMBER:
Rs 5000 (Or Above)
CORPORATE MEMBER:
Rs 10000 (Or Above)
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