To

The Executive Secretary & Director General
Bharatiya Vidya Bhavan
K.M. Munshi Marg, Chowpatty, MUMBAI 400 007, India
Phone: 23631261

Dear Sir,
I heartily endorse and subscribe to the principles, and ideals of Bhavan and request you to enroll me as a Life Member & Life-Subscriber for the periodical indicated below.

I have remitted Rs. 5000.00 by M.O. Cheque D.D.
Number.
on Bank.

1. Name
2. Address


3. Date of birth
4. Telephone Numbers.
Off. 
Res.
5. Periodical Opted:
Bhavan's Journal Navneet Hindi Navneet Samarpan
6. E mail Id:

Date     Signature

P.S. 1. Type the name and address in BLOCK LETTERS.
2. Intimate change in address whenever takes place.
3. Select the required option