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