Eleganza Club

Membership Number: ------------------------- Dated: --------------------------------

APPLICATION FOR INDIVIDUAL MEMBERSHIP

(Please use capital letters only)

I would like to enroll as a member of Club Eleganza (Avidipta I) (HIG), 401, Barakhola, Kolkata-700099.
Owner

Name in full : ......

Surname : ...
Date of Birth : ...
Residential Address : ... Stamp Size Photo
... Pin: . Self (2 Copies)
Corresponding Address : ..
...Pin : ...
Telephone (Resi.) :
Email : ......
Hobbies & Interest : ....

Nature of Business :
Name of Company :
Company Address :

Applicants Position :
(Kindly Attach Business Card)
Telephone Office : ..
PAN NO. :

Details of property in Avidipta I (HIG)

Customer Code Number : ..
Property Address :

If property is sold, the member is expected to inform the club management in writing for withdrawal of membership

(Verification by Marketing Department)

Acceptance of this form does not entitle the applicant to life time Membership of any of the club.
Granting and renewal of club membership is the sole discretion of the Management.
Membership Number: ------------------------- Dated: --------------------------------
DEPENDANT MEMBERS INFORMATION
(Please use capital letters only)

Name in full :
Surname : ...
Date of Birth : ...
School/College Present : ...
Name of the Organization : ..
(If Working)
Hobbies : ........

Name in full :
Surname : ...
Date of Birth : ...
School/College Present : ...
Name of the Organization : ..
(If Working)
Hobbies : ........

Name in full :
Surname : ...
Date of Birth : ...
School/College Present : ...
Name of the Organization : ..
(If Working)
Hobbies : ........

I am wholly responsible for paying the bills signed by my dependant.

Members holding dependant cards & Children will be familiarized with all rules and regulations.
Dependants are not allowed to bring guests to the club.

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Signature of Applicant
DETAILS OF MEMBERSHIP CARDS
(Please use capital letters only)

Membership Number :

Corresponding Address :

Phone No. : Pan No. :
E-Mail Address : ..

Name (Self) : Date Of Birth

Stamp Size Photo
Card No. : (2 Copies)
D D MM Y Y Y Y

Name (Spouse) : Date Of Birth

Stamp Size Photo
(2 Copies)
D D MM Y Y Y Y
Card No. :

Name (Dependant-I) : Date Of Birth

Stamp Size Photo
(2 Copies)
D D MM Y Y Y Y
Card No. :

Name (Dependant-II) : Date Of Birth

Stamp Size Photo
(2 Copies)
D D MM Y Y Y Y
Card No. :

Name (Dependant-III) : Date Of Birth

Stamp Size Photo
(2 Copies)
D D MM Y Y Y Y
Card No. :
TERMS AND CONDITIONS OF MEMBERSHIP
In case my guests accompany me I take total responsibility for their behavior in the club premises.
I accept the Managements right to cancel the membership if payment due is unpaid consecutively for two months.
I/We also under take to follow proper etiquettes including good and decent behavior in order to maintain the decorum of the
Club.
I am familiar with club rules & regulations. My co-operation will be extended in every manner to maintain the decorum and
Keep of the place.
I fully understand that the membership is valid only for two years (01 April 2017 to 31st March 2019 next year of part thereof)
And subsequent renewal/refusal without assigning reasons on annual basis is discretion of the management.
Acceptance of the application form does not entitle to lifetime membership. Granting of club membership is at the sole
discretion of the management.
The member & his dependents would abide by law of the land.
Payment can be made in Cash, Cheque, Demand Draft or NEFT in favour of Bengal Peerless Housing
Development Company Limited. NEFT DetailsAccount No: 005010200015905, IFSC Code: UTIB0000005 Bank
Name: Axis Bank Limited.
In case of emergency, to notify Arghya Chandra, Club Manager, 9830765377
(Name and Phone Number)
All dispute with respect to the terms and condition are subject to Kolkata jurisdiction.

Maintenance Fees of Club for two years for each flat = Rs. 12,000/- (@ Rs. 500/- per month per family of 4 members).
Usage Charge of all the club amenities for two years for each flat = Rs. 4800/- (@ Rs. 200/- per month per family of 4
members).
Registration Fees would be Rs. 100 for each card.
Loss and damage of each card would be Rs. 100/- for each card.
Service Tax @ 15% as on Date, subject to change as per Government Rules.

I have read and understood the above mentioned terms and conditions and agree to abide by the same.

Signature of the Applicant

Please mark the correct box (For property holder only, who are not residing in Kolkata)

Active Outstation

For Office Use only;

Particulars Amount(Rs.) Mode of Payment Cheque No. Date
Annual Subscription
Card Charges
Gross Amount
Service Tax
Net Amount Payble

FOR OFFICE USE ONLY

Cards Sent On (For Making)
Card Sent Member On ..