Global Federation For Nepali Literature (GFNL)         
                  Membership Form

   
   1 x Photo

1. First Name:
2. Last name:
3. Father or Mother Name:
4. Birth Place:                                                                                                                               Date:
5. Current/Postal Address:                                                                                                    

6. Age/DOB:                                                                                       7. E-mail 1st:
8. E-mail 2nd:                                                                                     9. Skype:   
10. Facebook:                                                                                       11. Phone:
12. Interest:
13. Published Books/CDs:

14. Involvement (Literature Organisation):
15. Job and Company:
16. Education:
You can deposit directly to GFNL Account via IME, Western Union or any Money Transfer Agent:
Bank: Laxmi Bank, Hattishar, Kathmandu, 
Account No: 00520021159
Name: GFNL (R/G/B)
सदस्यताको प्रकार र शुल्क:
१. आजीवन सदस्य नेरु ५,००० (Life membership US $50), २. संरक्षक सदस्य नेरु २५,००० (Patron membership US $250)
३. विशेष संरक्षक सदस्य नेरु ७५,००० (Special Patron membership US $710), ४. संस्थागत आबद्धता नेरु ३,००० (Affiliation membership NRs 30)
* Submit Application form to: gfnl@ymail.com,  facebook.com/nepaliliteratures,  More info www.gfnl.org 
---------------------------------------------OFFICIAL USE ONLY---------------------------------------------

Received by:                                                                Received Membership No: GFNL will give this number