Chotiwala's Ayurveda
Membership form for Chotiwala's Ayurveda Surgical & Yoga Research Centre
Serial No.
Membership Code :
Receipt No.
To,
The Secretary,
Chotiwala Ayurveda & Yoga Samiti
Paste Your Recent Stamp Size Photograph Here
Sir,
I S/o- W/o-D/o do hereby request you to grant me membership in the following category : (Tick whichever is applicable)
Founder Member
Patron Member
Life Member
Dignified Member
Respected Member
General Member
Other
Member's Particulars
1.
Name
2.
Sex
Male Female
3.
Father's /Husband's Name
4.
Age
5.
D.O.B
6.
Qualification
7.
Occupation
8.
Permanent Address
9.
Address for orrespondence
10.
Phone No. Residence with S.T.D.
-
11.
Phone No. Officewith S.T.D
-
12.
Mobile No.
13.
Email
14.
PAN No.
(With designation of Officer-Circle/Ward/Place)
15
Choice of Language in which Magazine Chotiwala's Ayurveda is desired
Hindi English
Declaration
I have read all the rules and regulations regarding the membership of Chotiwala's Ayurveda Surgical & Yoga Research Centre elaborated after the
application form and objectives of Chotiwala Ayurveda & Yoga Samiti attached with the application form. I shall abide by all the concerned rules and regulations. In the event of violation of concerned rules and regulations under any circumstances by me, the Chotiwala Ayurveda & Yoga Samiti is free to take any disciplinary action against me without assigning any reason thereof and I shall be entirely responsible for it. I now request you to enroll me as a member as per rules and regulations of the Chotiwala Ayurveda & Yoga Samiti.
I Accept I Decline
Account Sheet
For Membership of Chotiwala's Ayurveda Surgical & Yoga Research Centre
Serial No.
Membership Code
Receipt No.
Details of Donation
1.
Name of Donor And His/Her Full Address
2.
Phone No.Residence with S.T.D. code
-
3.
Phone No. Officewith S.T.D. code
-
4.
Mobile No.
5.
Email
6.
Category
(Tick whichever is applicable)
Founder Member
Patron Member
Life Member
Dignified Member
Respected Member
General Member
Other
7.
Details of Donation
(Tick whichever is applicable)
DD Cheque Cash Other
8.
Amount
9.
DD/Cheque No.
10.
 Date
11.
Name of Issuing Bank & Branch
12.
Name of Drawee Bank & Branch
13.
Receipt No.
14.
Date
Details of donation, if made earlier (Tick whichever is applicable)
DD Cheque Cash Other
1.
Amount
2.
DD/Cheque No.
Date
3.
Name of Issuing Branch
4.
Name of Drawee Branch
5.
 Receipt No.
6.
Date
Note : Drafts and Cheques should be in favour of “Chotiwala Ayurveda & Yoga Samiti”, payable at Bhopal.
Rules and regulations for membership of Chotiwala's Ayurveda Surgical & Yoga Research Centre alongwith its objectives.
1. All members are subject to the rules and regulations of the Chotiwala Ayurveda & Yoga Samiti, in existence.
2. Only individual membership will be accepted and membership is nontransferable. The Chotiwala Ayurveda & Yoga Samiti will be free to take any decision on the application of the natural heir of a member for the transfer of membership to him/ her on the demise of the concerned member
3. The membership does not entitle or create any right to the trusteeship of the Chotiwala Ayurveda & Yoga Samiti.
4. The membership is restricted to individuals (persons/ institutions) who undertake and agree to follow, observe and put into action the main objectives of the Chotiwala Ayurveda & Yoga Samiti which seeks to make life (a) physically healthy and (b) mentally sound (c) spiritually rich by use of ancient medical science of Ayurved and Ashtang Yog as well as generating patriotism among countrymen. The member should be totally committed to fulfilling the causes & objectives of Chotiwala Ayurveda & Yoga Samiti in spreading ancient knowledge of Yog & Ayurved in the country & abroad in order to improve the life-style, thinking & attitude of persons, thereby making human life sound, healthy, prosperous & free from any addiction (smoking, alcohol, tobacco etc.). In the event of membership by an institution, only a person, according to the laws of that particular institution, or a person nominated by that particular Institution may attain benefits of membership of Chotiwala Ayurveda & Yoga Samiti.
5. Donation for membership of Chotiwala's Ayurveda Surgical & Yoga Research Centre is entirely non-refundable.
6. Membership will be terminated automatically in the event of indulging in any activity which violates the rules and regulations of the Chotiwala Ayurveda & Yoga Samiti, tarnishes the image and harms the reputation of Chotiwala Ayurveda & Yoga Samiti.