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sample-readers club form
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Sri Velagapudi Ramakrishna Memorial College, Nagaram
Accredited By NAAC with B+An Institute with Autonomous Status
Application Form for Membership of Readers club (Available for students only)
I hereby apply for permission to join in Readers club of the Library for the period from _____________to _____________. My particulars are as follows:
1. Name of the Applicant : ___________________________
2. Father’s Name : ___________________________
3. Date of Birth : ___________________________
4. Gender (Male/Female) : ___________________________ 5. Class & Group : ___________________________
6. Address : ____________________________________________________
____________________________________________________
____________________________________________________
7. Class Number : ___________________________
Telephone/Mobile:_______________________ E-mail: _________________________________
I agree to abide by the terms and conditions as applicable from time to time. I also
understand that this permission is liable to be cancelled for unacceptable conduct or misuse on the report of the Librarian. I also understand that Librarian reserves the right to cancel permission without assigning any reason and no correspondence will be entertained on the issue.
Thanking you,
Yours faithfully,
Signature of the Student
LIBRARY USE ONLY
Register Number :
Date : Signature of the Librarian
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