APKOS Membership Form
Name of Applicant
Email
Age
Date of Birth (dd/mm/yyyy)
Mobile Number
Whatsapp Number
Residential Address
Permanent Adddress
Name of school presently working:
Address of school
Email address of school
Web Address of school
Present Designation
Principal
Senior Principal
Retired Pricipal
If retired, Name of school last worked
Address of school last worked
If you have any designation in APKOS, Please mention :
Do you want to join the free Group Insurance scheme of members:
Yes
No
Are you interested in joining contributory Group Medical Insurance ?:
Yes
No
Are you willing to take up any responsibility assigned by APKOS in future?
Yes
No
Do you have any personal suggestions or remarks ? :
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