Library_Membership_Form_for_UG_Students

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CENTRAL LIBRARY

University of Allahabad
Library Membership Form
Faculty of Arts
For U.G. Students

Session :

Name (Block Letters) : ______________________________________________________

Father’s Name : ______________________________________________________

DOB : -----------------------------------------------------------------------------------

Class : B.A Ist Year/B.A.IInd Year/B.AIIIrdYear

Department/ Institute : ______________________________________________________

Enrollment : ------------------------------------------------------------------------------------

Identity Card No. : ______________________________________________________


(Please attach photocopy)

Latest Fee Receipt No. :____________________________________________________


(Please attach photocopy)

Local Address : ______________________________________________________

____________________________________PIN_______________

Permanent Address : ______________________________________________________

____________________________________PIN_______________

Phone/ Mobile : ______________________________________________________

E-mail : ______________________________________________________

Date: _____________ _________________


Signature of Student

Forwarded by D.S.W

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