Membership Transfer Application Form

Appliction to be made in Triplicate – First copy to 41 Secretariat and other two copies to the 2 Clubs email: office41india@gmail.com

Member's Name

Current Club Number / Name

Proposed Transfer Club Number / Name

Office Address

Residential Address

Telephone Number n Whatsapp number

Mobile Number

Email address

Declaration by Current Club Chairman / Secretary:

I confirm that I have no objection to above transfer and the member has cleared all his dues to our Club

A fellowship of young professionals committed to nation-building through service, friendship, and impactful projects since 1962.