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LIFE MEMBERSHIP FORM

The Undersigned is interested to be a member of ISNA and is agreed to obey its rules and regulations.
Name in full (Capital Letters)* :
Date of Birth* : (e.g dd/mm/yyyy)
Academic Qualifications* :
Affiliation(if any) :
Areas of Interest :
Profession and Designation :
Professional Experience :
Corresponding Address* :
Phone :
E-mail(if any) :
  :

* These are mandatory fields
* Membership is subjected to the approval of the Council.

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In case of Life Membership, the Cheque/draft (Payable in Kolkata) should be issued in favour of Indian Science News Association A/C Life Fund.
Life Membership fee..........................Rs.2,500.00

* Outstation cheques should include Bank commission of Rs. 75.00


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