Membership Form

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Membership Form

Membership Fees --- Donor member Rs.5000/-, Life Member Rs.1000/-, Ordinary Member Rs.100/-, Institutional Member Rs.2500/-(one year)

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Initials *

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Mr.

Ms.

Dr.

Km.

Smt.

Name In Full *

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Date of Birth *

MM

/

DD

/

YYYY

Qualification *

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Name of Institution/Office *

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Designation *

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Pay scale

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Correspondence Address *

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Permanent Address *

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