NATIONAL NEWS PAPER - AIITA
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Application Form to be filled-in by the applicant accompanied with 2 stamp sized photographs NATIONAL NEWS PAPER Member of PCI (Govt of India) Reg. No. (Govt. of India) MPHIN 17569/2006 | Postel Regd. No. MP/ICD/1054/2009-11 1. Name ........................................................................................................................................................ 2. Occupation/Service .................................................................................................................................. a) Designation............................................ b) Nature of Assignment : Full Time Part Time Contractual Other 3. Father’s / Husband’s name ..................................................................................................................................................... 4. Qualification ......................................................................................................................................................................... 5. Date of birth ......................................................................................................................................................................... 6. Blood group ......................................................................................................................................................................... 7. Nationality ............................................................. Email: ................................................................................................... 8. Present Residential Address .................................................................................................................................................... Telephone (R).......................................................................Mobile ........................................................................................ 9. Address during last 3 years (if different from no.8) ............................................................................................................... ................................................................................................................................................................................................. 10. Journalistic experience for last 3 years with details................................................................................................................. (Enclose copy of the certificates for proof) Media Agency ........................................................................................................................................................................... Type of News Organization (Please specify) Newspaper Magazine Radio Television Agency Photo Agency Others (please specify).............................................................................................................................................................. Roll (Please specify) Correspondent Radio Commentator TV Commentator Photographer TV Camera Person Technician Others (Please specify) ............................................................................................................................................................. ................................................................................................................................................................................................... Affix stamp size recent coloured photograph Regd. Office: Alma Times, 18/3, Pardeshipura, Near Electronic Complex, Indore (M.P.), India Ph: 0731 4222242, 4222252, 4055505 | Fax : 0731 2573779 Email : [email protected] | www.almatimes.in, www.almatoday.com
Transcript of NATIONAL NEWS PAPER - AIITA
Application Formto be filled-in by the applicant accompanied with 2 stamp sized photographs
NATIONAL NEWS PAPERMember of PCI (Govt of India) Reg. No. (Govt. of India) MPHIN 17569/2006 | Postel Regd. No. MP/ICD/1054/2009-11
1. Name ........................................................................................................................................................
2. Occupation/Service ..................................................................................................................................
a) Designation............................................
b) Nature of Assignment : Full Time Part Time Contractual Other
3. Father’s / Husband’s name .....................................................................................................................................................
4. Qualification .........................................................................................................................................................................
5. Date of birth .........................................................................................................................................................................
6. Blood group .........................................................................................................................................................................
7. Nationality ............................................................. Email: ...................................................................................................
8. Present Residential Address ....................................................................................................................................................
Telephone (R).......................................................................Mobile ........................................................................................
9. Address during last 3 years (if different from no.8) ...............................................................................................................
.................................................................................................................................................................................................
10. Journalistic experience for last 3 years with details.................................................................................................................
(Enclose copy of the certificates for proof)
Media Agency ...........................................................................................................................................................................
Type of News Organization (Please specify)
Newspaper Magazine Radio
Television Agency Photo Agency
Others (please specify)..............................................................................................................................................................
Roll (Please specify)
Correspondent Radio Commentator TV Commentator
Photographer TV Camera Person Technician
Others (Please specify) .............................................................................................................................................................
...................................................................................................................................................................................................
Affix
stamp
size recent
coloured
photograph
Regd. Office: Alma Times, 18/3, Pardeshipura, Near Electronic Complex, Indore (M.P.), IndiaPh : 0731 4222242, 4222252, 4055505 | Fax : 0731 2573779
Email : [email protected] | www.almatimes.in, www.almatoday.com
Editor ALMA TIMES
Reference of two citizens of your locality :
Sn. Name Occupation Tel. No. Address
Signature of Designated Police Authority with Official Rubber Stamp
Self-Declaration :
I,........................................................................... hereby DECLARE that the particulars given are TRUE to my knowledge and
belief and nothing has been concealed. I would abide by all the prevailing and future rules and regulations, laws and ethics.
VERIFIED at Indore on this .............. day of ..................................20.........
Signature of the applicant
Membership No. Receipt No.
Issue Date : Valid Upto :
Police Verification
1. Documents to submit
a) Recommendation letter from the Editor
b) Appointment letter of the last assignment
c) Identity and address proofs
d) Two passport sized recent colour photos
e) Membership Fee of Rs. 1200/- (inclusive of all charges) - Annually.
must be deposited by a DD in favour of "ALMA TIMES" Indore (Madhya Pradesh)
2. Directives
a) Members to follow the rules of Alma Times
b) Members to follow the code of conduct
c) Members to use only valid Identity Card
d) Misuse/ illegal action, shall result in termination of membership
e) Members to report related news for press to the editor - Alma Times
f) Be enrolled in the local press club
g) In case of Identity Card lost, inform nearest Police Station & Alma H.Q.
h) Rs. 600/- shall be charged to issue duplicate Identity card
Particulars of Press Card
Important Information to attend
