Thursday, 14 April 2016

Membership Application Form

Dear Comrades! The Membership to AIPRPA is to be obtained in the following format of Application Form only. Any other form used earlier should be replaced by the following format and kept in the file of the District / Divisional Association. A copy of the application forms should be photocopied and sent to CHQ for records. The State General Secretaries are requested to guide their District / Divisional Secretaries in this regard. 

Model Membership Application form is as follows:  


( Registered No: 83/2015 under Tamilnadu Societies Registration Act 1975)

_______________________________District / Division




1.      Name of the Pensioner           :

2.      Postal Address                         :


3.      Landline & Mobile No             :

4.      E-Mail ID                                 :

5.      Date of Birth                           :

6.      Date of entry in Govt.Service :

7.      Date of Retirement                 :

8.      Post held on retirement          :

9.      Office last worked                  :

10.  Scale of Pay at the time of

Retirement                              :

11.  PPO No. & Issuing Authority   :

12.  POSB or Name of Bank from

Where Pension is drawn         :

13.  Total Service in Department  :

14.  Any other details if any           :




I declare that I am a Postal Pensioner and I wish to join as a basic member of All India Postal & RMS Pensioner Association on payment of annual subscription 200/- / or / Life Membership 2000/-. I understand that this is a voluntary association to work for the welfare of the pensioners and I assure that I shall abide by the bye-law of the Association and I am remitting this annual subscription / or / life membership subscription for the period from January ______ to December ______.



Date:                                                                                                        Signature of the Pensioner

Membership No:


Signature of District / Divisional Secretary:

General Secretary AIPRPA

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