Membership for the Financial Year2021-22 Enter your full name Name * the topic of your message Nationality * 0 of 20 max characters. Blood Group * 0 of 10 max characters. Country Code * e.g. In case of Indian Mobile Number, enter 91 Your Email* Enter a valid email ID proof type * Address Proof type * [Optional] Were you a member of BSS in past? Title *MrMrsMs Father’s /Husband’s /Guardian’s Name* Date of Birth * MM-DD-YYYY Present postal address * Mobile Number * Permanent Address * ID Proof Number Address Proof Number [For New Members] Referred by: Please provide the name of any BSS member whom you know well and who can introduce you to BSS. This question is only for new members. Not required if you are/were members of BSS. [For New Members] Any other details you would like to provide* Use this space to tell about yourself and let BSS team know why you would like to part of BSS. I request the Bengaluru Sreehatta Sammelani to enroll me as a registered member of the association. I undertake to abide by the bye-laws of the association and to actively participate in the accomplishment of aim and objective of the association. I understand BSS will not be held responsible for any actions carried out by me in my personal capacity and also agree to indemnify BSS for any misdeeds from my end that causes disrepute to BSS or any/all of it's member/s. *YesNo
