THE SHILLONG MANIPURI STUDENTS’ UNION Estd. 1976, Regd.No.E-16 (RS) 30/2001/149 0f 2002 H.Q. Manipur House, Red Land, Laitumkhrah, Shillong-03 STUDENT’S MEMBERSHIP FORM 2022 SL NO. ……………….. I, Shri / Shmti ……………………………………………………………………………………………………………………………….. wish to enroll as a member of the Shillong Manipuri Students’ Union. Hence my particulars are given below: Full Name (in block letters): …………………………………………………………………………………………………………………………………………...………………………………………. Correspondence / Hostel Address (in block letters): ………………………………………………………………………………………………………………………………………………….………………………………… ………………………………………………………… Age …………… E-mail ………..……………………………………….. Gender (M/F) ……………. Mobile No. ………………………………………… Guardian’s / Parent’s Name ...…………………………..……………………………………….... Occupation …………………………..……………………… Contact no ………………………………….. Permanent Address (in block letters): ………………………………………………………………………………………………………………………………………………………………………..…….……. Post Office ……………………..……….. Police station ……………………………. District …………………….. State ………………….…….….. Name & Address of the Institute/University/College/School: …………………………………………………………………………………………………………………………………………………………………………….……… …………………………………………………………………………………………………………………………………………………………………….……………… Details of Education Qualification: Class …………………………….…. Honors ( ) / General ( ) Subject …..……………..……….. Year/Semester of study ………………………………….. Board ……………………………. No of days / months / years in Shillong ………………………… Declaration: I do hereby declare that the information mention above is true to the best of my knowledge. I also agree to abide by rules and regulations of the Union. I will share my best efforts to any development activities of the union. Date: ……………………… Place: …………………………… Signature: …………………………….… N.B. 1. You are request to submit your membership form along with two passport size photos with Rs. 300/- for the registration fee. (Note that this registration is one time & valid till the completion of your registered course) 2. Union will collect Rs.20/- every month from the student as a fund and for maintenance of the office. 3. Student should well behave and dress decently. They must attend to any occasions / meetings organize by Union or call by the Union. 4. Students who failed to register themselves in the Union shall be remarked as unknown. Neither entertain nor responsibilities shall be made in any of problems arise or any circumstances face by any whosoever.
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