MEMBERSHIP
Persons
with disabilities who would like to become members of C. T. Orthopedic Disability
Association should fill in the “Membership
Application Form” which can be obtained from the Secretariat
of the
Association
Center
. Attached
to the form they should submit a Medical Commission Report, one photo
taken within the last six months and the annual fee, to the
secretariat. When all of the above is complete, the membership
procedure will start immediately.
For Further Information, please call: 2238436 or 2238437
Name –
Surname:................................................
ID Number::..................................
Father’s
Name:...................... Mother’s
Name:.........................
Place of Birth:.......................... Date of Birth:.............................
Degree of
Disability:........................
Cause of
Disability:...................................................................................................
Type of
Disability:........................................................................................................
Whether He/She
is receiving Rehabilitation:.....................................................................
Education
Status:............................ Status of Motor Vehicle Driving
Ability:.........................
Medical
Equipment:...................................................................................................
Interest in
Sports:............................................................
Phone Number:
Home:.............................. Work:.....................
Mobile
:...........................
E-mail Address:.........................................................
Date of
Disability:..........................
Marital Status::......................... Name of Spouse:................... Number of Children:............................
District:........................................
Home Address:...........................................................................................................................................
Work Address:.............................................................................................................................................
Source of
Income:................................... Occupation:.......................................................
Signature of
the Member: Name of the Registrar: Date of Registration
.......................
................................. ...................
Follow up
Topics: ...........................................................................................
.........................................................................................................................................
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