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Subscription Form

Dimdima Subscription Department
Bharatiya Vidya Bhavan
505, Gora Gandhi Compound, 
Sane Guruji Marg
Tardeo, Mumbai 400034
Phone: (022) 23526025

From

	Name:	_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
	Address:	_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
	City:	_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
	State:	_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
	Country:	_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
	Pin:	_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
	E-mail:	_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
	Phone:	_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Sent herewith a Demand Draft / Pay Order/ Cheque* in favour of
"Bharatiya Vidya Bhavan", Mumbai for
Rs._ _ _ _ _  Dated _ _ _ _ _ _ _ _ _ _ _ Drawn on bank_ _ _ _ _ _ _ _ _ _ __ _
towards 1 year / 2 years / 3 years Subscription of DIMDIMA Magazine

Date

Signature

* Allow 4 weeks to process order if accompanied by Demand Draft / Pay Order / or Mumbai Cheque and 6 weeks in case of Cheques from outside Mumbai.