YPS Individual Membership Application

This form should be used only for registering for Individual Membership. Existing members wanting to become Life Members should fill paper application and speak to YPS President / Secretary to confirm eligibility.

* - Required Field

*First Name
*Last Name (required)
*Salutation Mr.Ms.Mrs.Dr.
*Gender (required) MaleFemale
*Date of Birth +
Blood Group
*Your Email
*Your Mobile
Residential Telephone
Office Phone
Education
Professional Qualification
*Residential Address
Office Address
Areas of interest in Photography
Distinctions in Photography
Other Hobbies
Profession, Company, Designation
*How did you learn about YPS FriendWebsiteFacebook
Introduced By
Payment Details
*Method of Payment

Bank & Branch Canara Bank, DVG Road
IFSC CNRB0000473
Account Name YOUTH PHOTOGRAPHIC SOCIETY
Savings Account No 0473101016126
*Date of Payment +
*Amount Paid - (Rs. 250 for Oct 17-Mar 18 + Rs. 500 for Apr 18-Mar 19 + Rs. 50 Admission Fee)
*Payment Reference (Receipt Number etc.)
Any other additional information
*Upload your profile photo (less than 200KB)

I confirm that the details provided by me are correct and that I read and understood the Terms and Conditions

I agree to the Terms and Conditions on the YPS Website and will fully abide by the laws of Youth Photographic Society

Signed by me

* Required Field
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