REGISTRATION FORM

 
Name
Address
Phone Resi.
Phone Off.
Mobile
Fax
Email  
Educational Qualification
Professional Qualification
Company
Area of Interests
Personality


Full  Membership fee -  Rs. 200 .
The membership fee is not refundable upon membership termination.


I hereby declare that the information furnished above in complete and true to the best of my knowledge.
I will pay the fee on the respective counter after filling the form.