MEMBERSHIP APPLICATION FORM
CENTRE FOR BIODIVERSITY CONSERVATION AND ECOSYSTEM MANAGEMENT (CEBCEM)
BIODATA
Title
Name
Date of Birth
MM
/
DD
/
YYYY
Gender
INSTITUTIONAL AFFILIATION
Institution Name
Department/Unit
Rank/Designation
CONTACT DETAILS
Address
Mobile Number
E-mail address
QUALIFICATIONS
Highest degree
Area of Specialization
Research Interest(s)
Professional Affiliation(s)
GRANTS WON IN THE LAST 10 YEARS
PATENT (If Any)
TYPE OF MEMBERSHIP SOUGHT (FULL OR ASSOCIATE)
RESEARCH GROUP BEST SUITED
Kindly attach a short brief on your reason for wishing to join CEBCEM *
Hints: How would you contribute to helping in achieving the visions of the Centre (not more than 500 words) and attach a one-page resume along with your CV.
Required
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