| SUBSCRIPTION FORM : |
| Name : _________________________________
|
| Mailing Address: _________________________________ |
| City: ___________________ State: ____________________ |
| Pin: ___________________ Phone: ___________________
|
| Subscription No.: _________________________________
(Existing subscriber) |
Please find enclosed a sum of Rs_________________ by DD/Cheque/MO, |
No. ___________ Bank___________________ Date _____________
|
| In favor of “Karpagam Charity Trust”, Coimbatore . |
| Signature |
| |
| |
