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Name of Applicant with Title
Surname of the Applicant
Address - Residence
Telephone - Residence
Date of Birth
Name and Address of School
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*
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Signature of Parent/Guardian*
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