MEMBERSHIP

*INDIAN PANGRATION ATHLIMA FEDERATION*

*Check The Type Of Membership You Are Applying For*

Athlete	Rs 200.00 Fee

Coach	Rs 500.00 Fee

Official	Rs 500.00 Fee

Club	Rs 1000.00 Fee

State Director	Rs 2000.00 Fee (Minimum of 12 Clubs)

Regional Organization	Rs 5000.00 Fee

National Organization	Rs 5000.00 Fee

Disabled Organization	Rs 3,000.00 Fee

Public Sector Membership	Rs 100.00 Fee
Name:___________________________________ Age: _____ DOB: __________ Sex: _____ Address: ______________________________ City: ________________ St: ____ Zip: _______ Phone: (_______)_________________ Fax: (________)_________________ Email Address: _________________________________________________________ Instructor: ___________________________ Martial Art: ____________________________ Signature: __________________________________ Rank (If Any) ____________________

Make Check or Money Order Payable To: SECRETARY GENERAL INDIAN PANGRATION ATHLIMA FEDERATION