08.08.2015 Views

Thiya Samaj Mumbai - 71st Annual Report 2014 - 15

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NOMINATION FORMThe Hon. Gen. Secretary,THIYA SAMAJ,G-4 Pallavi, Pantnagar North,Ghatkopar East, <strong>Mumbai</strong> 400 075Dear Sir,I am a member of <strong>Thiya</strong> <strong>Samaj</strong>, <strong>Mumbai</strong>. I would like to work for the <strong>Samaj</strong> as (tick anyONE of the following):1. Member of Managing Committee2. Chairperson - Western Region Ladies Wing3. Editor - <strong>Thiya</strong> BelakuI agree to abide by the bye-laws of <strong>Thiya</strong> <strong>Samaj</strong> in this regard. I am not a member of anyother sub-committee of <strong>Thiya</strong> <strong>Samaj</strong>. I would therefore request you kindly to include myname in the list of nominations for the said post.Thanking you,Yours truly,Date:SignatureName : _______________________________ Membership No.: ________Address : ____________________________________________________________________________________________________________Contact Number: _____________________________________________Proposed by: ________________________________________________Name: ________________________________ Membership No.: ________Address : ____________________________________________________________________________________________________________Contact Number: ________________________ Signature: _____________Seconded by : _______________________________________________Name: ________________________________ Membership No.: ________Address: ____________________________________________________________________________________________________________Contact Number: ________________________ Signature: _____________

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