INDIAN FAMILY OF CEREBRAL PALSY (IFCP) Application form for LIFE MEMBERSHIP / DIRECTORY / SUBSCRIPTION / DONATION I wish to enroll my self as a Life Member of Indian Family of Cerebral Palsy (Rs.2,000/ US $ 150/-) / to purchase Indian Directory of Cerebral Palsy (Rs.325/-)/ to Subscribe IFCP Newsletter for three years (Rs.300/ US $ 50/-)/ Donation to IFCP. Download Membership Form
Name of the member/Subscriber/Donor
age	Profession
Name of the child with cerebral palsy/CP Organization, if any
Date of  birh of the child with cerebral palsy if any/Date of foundation of organization
Herewith I am enclosing Cash/Cheque/DD No
Drawn on
Dated	Rs
In words
Name :
Hno:	House Name
Lane/Cross/Street	Colony
Post	City/Village
PinCode	District
State	E-mail
Phone(STD Code)	Fax

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For life membership – I will abide by the constitution of IFCP. If found guilty, I may be removed from the association. (DD or crossed cheque to be issued on the name of Indian Family of Cerebral palsy, Hyderabad) (Kindly prefer to give DDs only. However, if not possible, please add Rs.40/- for outstation cheques)   Download Membership Form