PWC | OLD BOYS' ASSOCIATION

PRINCE OF WALES' COLLEGE OLD BOYS' ASSOCIATION

Title

First Name *

Surname *

Address Line 01 *

Address Line 02 *

Birthday *

NIC *

Email Address *

Telephone Number (Mob.) *

Telephone Number (Res.)

Admission Number or Admission Year *

Profession

I hereby undertake to pay LKR 2,000.00/ 500.00 (Rs 500.00 for those under 23 years of age) as life membership fee.

Upon qualification of my application to present to the executive committee for approval of membership.

I agree to abide by the rules and regulations of the association.

Introducer's Membership Number

Introducer's Name