IV Floor, City Centre, Round West,
Thrissur 1, Kerala, India.
Tel : +91 487 2321301 (4 lines), Mob: 98954 30664, 9447032114
email:
trc_kipcpl@sancharnet.in
Near Elite
Mission Hospital, KOORKENCHERY, Thrissur.
REGISTRATION FORM
Name (in full)
Name of Father/Husband
Age
Date of birth
Occupation
Permanent Address
Village
Taluk
Address for communication
If non-resident, address abroad
Telephone No.
Mobile No.
Fax No.
email
Name of spouse
Age
Date of Birth
Employed
not employed
If employed, Designation and
Address
Apartment No.
Type
Cost per Sq.Ft.
Total Cost
Payment details:
Amount Rs.
(Rupees
only)
To be paid in 18 installments.
All Payments should be by Demand Draft payable at Thrissur in favour
of Daya Kap Developers and crossed account payee only. Local
cheques are also accepted.
