Junior Membership

Name of Applicant with Title *

Surname of the Applicant *

Address - Residence

Telephone - Residence *

Date of Birth *

Name and Address of School

Email Address *

Special Interests in Wildlife and Conservation

Name and Membership No. of Parent/Guardian if Member of WNPS

Name of Parent/Guardian

Membership No. of Parent/Guardian

Declaration of applicant

I declare that I have not been convicted of any offense under any enactment relating to the protection of wildife and nature.

I further declare that I will uphold the objects of the society and adhere to its rules.

I attached Rs (500/-) being subscription for the current year.

Signature of Applicant Upload Your Signature only in .doc/.docx/.pdf/.jpg/.png

Signature of Parent/Guardian Upload Your Parent/Guardian Signature ONLY in .doc/.docx/.pdf/.jpg/.png

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