Ernakulam Housing Society:

Application

Selection form of housing scheme

Name of the member *
Address for communication *
Phone number *
Member number *
Plot number Selected *	First Second Third Fourth
Extent of plot in Cents *
Rate of plot per Cent *
Total land value *
I am remitting herewith an amount of Rs *being the 30% of the total plot value.The balance will be remitted as per the intimation of the Society.