YOUNG FRIENDS OF AL-SHIFA Trust
MEMBERSHIP FORM (Printable Version)
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Name _____________________________________________________
DOB ________________
Sex?? Male ??????????? Female
Educational Qualification _____________________________________
Father’s Name ______________________________________________
Country __________________________________
District ___________________________________
City ______________________________________
Contact # (Phone) __________________________
Address ___________________________________________________
E-Mail _____________________________________________________
Name Of School/College ______________________________________________
Address Of School/College ____________________________________________
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Al-Shifa Trust Eye Hospital, Jhelum Road, Rawalpindi, Pakistan. Tel.: 9251-5487820 Fax: 9251-5487827
Email: [email protected]???? Web: alshifa-eye.org.pk