WEALTH MANAGERS INVESTMENT GR UP

A-9 G.D. Colony Mayur Vihar Phase-3 KINDLY AFFIX YOR

New Delhi- 110096 LATEST PHOTOGRAPH
Phone Number : - 011-22626832 AND SIGN

JOINING APPLICATION FORM

DATE OF JOINING________________ MEMBER CODE_______________________

NAME OF APPLICANT ___________________________________________________________________

FATHER’S / HUSBAND’S NAME___________________________________________________________

SEX MALE / FEMALE _______________________DATE OF BIRTH______________________________

PLACE OF BIRTH____________________________ CITY_______________________________________

MARITAL STATUS SINGLE______________MARRIED______________DIVORCED______________

NATIONALITY________________________ PAN NO. _________________________________________

PRESENT ADDRESS WITH PIN CODE _____________________________________________________

________________________________________________________________________________________

PHONE NO._____________________________ MOBILE NO.____________________________________

NAME OF NOMINEE_____________________________________________ SEX MALE / FEMALE

RELATIONSHIP WITH NOMINEE__________________________________________________________

JOINING FEE ___________________SPONSER CODE__________________________________________

APPLICANT SIGNATURE_______________________SPONSER SIGNATURE______________________

PAYMENT DETAILS

CASH / DD / PAY ORDER NO.____________DATE________________AMOUNT___________________

AMOUNT IN WORDS_____________________________________________________________________

NAME OF BANK & BRANCH______________________________________________________________