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Individual / Institution member *

Individual
Institution

Individual Membership *

Individual Member: Annual Subscription : Rs. 1,000/-
Individual Member: Life Membership : Rs. 10,000/-
Young Member (below 35 years age)/ Research Student : Rs. 500/-

Individual Member (Annual Subscription )
individual-lifetime: Individual Member (Life Membership)
Young Member (below 35 years age)/ Research Student

Annual or Life Membership (10 years) *

Institutional Member:
Annual Subscription : Rs. 20,000/-
Life Membership (10 years) : Rs. 2,00,000/-

Annual Subscription
Life Membership (10 years)

Name *

Designation

Name of the organization

Date of Birth

Mailing address

Tel *

Fax

Website URL

Status

Representatives of Organisation

(Give the names and addresses of representatives)

(a)