IACLALS MEMBERSHIP DATABASE
Existing Members: Please fill this to help update our database.
New Members: Please fill this form only AFTER making the payment.
Title (Ms./ Mr./ Dr./ Prof.)
Full Name *
Email Address (Primary) *
Email Address (Alternate)
Designation (for faculty)/ Course (for student members)
Name of the Organization (Department, College, University etc.) *
Address of the Organization *
Contact Number (Whatsapp)
Contact Number (Default/Calling) *
Postal Address (Residential with Pin Code)
Kind of Membership *
Membership No./ID (if allotted)
Date of Membership/ Payment
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