MEMBERSHIP

MEMBERSHIP
Who Can Become a Member?


Membership is open to:
• Senior citizens aged 60 years and above
• Residents of Kerala
• Individuals willing to uphold the values of the Society
Membership is open irrespective of gender, religion, caste, or background.
Benefits of Membership
Members gain:
• A reliable support network
• Guidance and advisory assistance
• Opportunities for social engagement
• Participation in cultural programs and travel
• A community that respects and values them

MEMBERSHIP FORM DOWNLOAD(CLICK HERE)

ANANTHAPURI SENIOR CITIZENS CHARITABLE SOCIETY (ASCCS)

“Help Each Other in the Evening of Life.”

Regn. No.: TVM/54/2026
Pravachambalam, Convent Road, Nemom (P.O.),
Thiruvananthapuram, Kerala – 695020
Website: www.ananthapurisccs.com | Email: asccstvpm@gmail.com

MEMBERSHIP APPLICATION FORM

 

For Senior Citizens Above 60 Years of Age

Membership No.: _________________________
Date of Application: _______________________

1. PERSONAL DETAILS

Full Name:  ___________________________________________

Date of Birth: ____ / ____ / ________
Age: __________ Years

Gender:
☐ Other / Prefer not to say  ☐ Female  ☐ Male

Marital Status:
☐ Other ☐ Divorced ☐ Widowed ☐ Unmarried ☐ Married

Occupation / Previous Occupation:

Qualification: ____________________________

2. CONTACT DETAILS

Residential Address:

District: ___________________________
PIN Code: _________________________

Mobile Number: ____________________

Email Address: ___________________________________

Alternative Contact Number:  _______________________

 

 

3. EMERGENCY / FAMILY CONTACT

Name of Contact Person: _________________________________

Relationship: __________________________

Mobile Number: ____________________________________

Address:

4. MEMBERSHIP & INTERESTS

Why would you like to become an ASCCS member?
☐ Companionship & Friendship
☐ Social Activities
☐ Travel & Tours
☐ Cultural Programmes
☐ Music & Entertainment
☐ Sports & Recreation
☐ Welfare & Support
☐ Awareness Programmes
☐ Volunteering / Community Service
☐ Other: _________________________________________________                              …2/-

-2-

 

Activities you are interested in:

Would you like to participate in ASCCS programmes and activities?

☐ Depending on availability  ☐ No  ☐ Yes

5. SPECIAL REQUIREMENTS / SUPPORT

Do you have any specific requirements that ASCCS should be aware of for participation in programmes or activities?

☐ No
☐ Yes — Please specify:

6. VOLUNTEERING

Would you be interested in contributing your time, knowledge, skills, or experience to ASCCS activities?

☐ Maybe in the future  ☐ No  ☐ Yes

Areas in which you would like to contribute:

MEMBER DECLARATION

I hereby apply for membership of the Ananthapuri Senior Citizens Charitable Society (ASCCS).I declare that the information provided by me in this application is true and correct to the best of my knowledge.I understand that membership and participation in ASCCS activities are subject to the rules, policies, procedures, and decisions of the Society.I agree to respect the dignity, privacy, rights, and well-being of fellow members and to maintain a spirit of friendship, cooperation, mutual respect, and community service. I understand that ASCCS is committed to supporting senior citizens irrespective of religion, caste, creed, gender, political affiliation, or social background.I agree to abide by the applicable rules and guidelines of ASCCS.

Place: ___________________________

Date: ____ / ____ / ________

Name: ______________________________                                    Signature of Applicant

 

FOR OFFICE USE ONLY

Application Received On: ____ / ____ / ________

Membership Category: __________________________________

Membership Approved:
☐ Pending  ☐ No  ☐ Yes

Membership No.: ______________________________________

Date of Approval: ____ / ____ / ________

Remarks:

Authorized Signatory

Name: ________________________ Designation: ______________________________

Signature: ________________________________

ASCCS Seal

NB : This Membership Form can be downloaded from the DOWNLOAD section of the www.ananthapurisccs.com website and can be sent through the email ID :asccstvpm@gmail.com or by post alongwith a cheque/DD for  Rs. 200/- as membership fees payable at SBI Pravachambalam,Thiruvananthapuram  Branch. Membership confirmation will be sent through email/whatsapp of the given phone number and a call will be made to  the member informing the future events of the organization. Once you become the member you are eligible to participate all activities of the charitable society.

 

 

 

 

Important Note – Membership Application

The ASCCS Membership Form can be downloaded from the Downloads section of the official website: ananthapurisccs.com.

After completing the form, applicants may submit it either:

  • By Email: asccstvpm@gmail.com
  • By Post: Send the duly completed and signed Membership Form along with a Cheque/Demand Draft (DD) for ₹200/- towards the membership fee, payable at SBI, Pravachambalam Branch.

Upon receipt and verification of the application and membership fee, membership confirmation will be communicated through email or WhatsApp to the contact details provided in the application.

ASCCS will also contact the new member by phone to provide information about forthcoming programmes, activities, events, and other initiatives of the Society.

Once membership is confirmed, the member will be eligible to participate in the activities and programmes of ASCCS, subject to the applicable rules, guidelines, and programme-specific requirements of the Society. 

ASCCS MEMBER’S COMMITMENT

Join ASCCS – Together We Stand, Together We Care, Together We Live with Dignity.

Help Each Other in the Evening of Life.Together We Stand. Together We Care.Together We Live with Dignity.The Golden Years Deserve Golden Care.You are never alone when ASCCS stands with you.“You Inform – We Act – Without Limits.