MAHATMA GANDHI UNIVERSITY LIBRARY PRIYADARSHINI HILLS P.O, KOTTAYAM-686 560, Ph: 0481-2731018 APPLICATION FOR MEMBERSHIP Vice Chancellor, Pro-Vice Chancellor, Syndicate Members, Registrar, Finance Officer, Controller of Examinations Membership No:

1. Name [In Capitals]

:

2. Date of birth

:

3. Designation

:

4. Official Address

:

Male/Female:

5. Duration of present tenure :

6. Permanent Address

:

7. Phone Number & Email

:

8. Blood Group

:

I hereby apply for membership of the University Library. I have read the Library Rules and agree to abide by them. Place:

Signature:

Date:

Name:

(Office Seal)

______________________________________________________________________________________________________

(For office use only) Receipt No. & Date: Admitted by Name and Designation:

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