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Vidarbha Olympic Association


MEMBERSHIP APPLICATION FORM

Please return completed form by to :
Vidarbha Olympic Association

Address: Matoshree 70/G, Paradise Society, Sonegaon, Khamla, Nagpur [M.S.] India,
Email: vid.olympic2009@gmail.com, Phone: +91-9423101619


Applicant Information :

Organisation:      _________________________________________________________________
Contact position:      _____________________________                                                              Title: Ms/Mr/Dr/Prof/other:_________________________
Contact First Name: _____________________________                                                              Surname:______________________________________
Address:                  ________________________________________________________________
Country:                  ________________________________________________________________
Phone:                    ______________________________                                            E-mail:________________________________________
Fax:                        ______________________________                                             Website:_______________________________________










  1. Receiver:         Vidarbha Olympic Association
  2. Bank:                State Bank of India
  3. Account No:    31680302154
  4. IFSC Code:       SBIN0008239
  5. Branch:            Surendra Nagar, Nagpur

    Required Attachments :

  • Organisation structure incl. Board Members.
  • Oraganisation statutes constitution Regd. Certificate.
  • Proof of payment of annual fee for current year(if membership is denied, this will be refunded)
  • Notes on applicant' s recent achievements in the field of related Sport.
  • Notes on applicant's future priorities in the field of Sport & physical activity.
  • A copy of the applicant's certificate of legality as issued by the relevant authority.













Other Comments:________________________________________________________________________


Signature:_________________________________                                                                          Date:___________________________________

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