To
The Chairman, PeRGo,
Sir, I am in agreement with the objectives (Available on website) of the Society i.e. People for Responsible Governance (PeRGo) and I am desirous of becoming a member thereof. I agree to abide by the Constitution, Regulations and Bye-Laws of the Society, as may be applicable from time to time.
Name (required)
Father’s Name (required)
Gender(required)MaleFemaleother
Date of Birth (required)
Academic Qualification
Profession Mobile No
Email ID (required)
Membership Fee details (Amount, date, mode)
Present Postal Address
Permanent Address
Are you a Senior Citizen NoYes If yes, please state your date of birth (Please attach Xerox copy of evidence of age) Statement of the Purpose (SoP): (Please write briefly as to (a) why are you interested in becoming a member of the Society? (b) How you expect to benefit by becoming a member. I have deposited an amount of Rs. in the account of society, vide reference no.
dated the particulars whereof are given below: Account Name – People for Responsible Governance - PERGO SB Account No. – 18330110033340 IFSC Code - UCBA0001833 Bank Name – UCO Bank, HP High Court Branch, Shimla, HP Annual Membership Fee – Rs. 1200/- Life Membership Fee - Rs. 5000/-