MEMBERSHIP FORM

THE JADAVPUR ASSOCIATION OF INTERNATIONAL RELATIONS
Membership Form
FOR TEACHERS/PROFESSIONAL/STUDENTS
Title: Dr./Mr./Ms./Mrs.-------------
Surname:_________________________

First Name____________________________
Address for communication:___________________________________________
Street/House No:___________________Street Name:______________________
City________________PIN__________State_____________________________
Mobile:___________________________ Tel_____________________________
E-Mail:___________________________________________________________
For National /International Members:
STD/ISD Code____________________ Country Name_____________________
Country Code_____________________Postal/ZIP_________________________
Occupation:______________________
Institute of Affiliation:_______________________________________________
Address:_________________________________________________________
Sex:Male/Female _________________Date of Birth: (DD/MM/YY)_
PAYMENT DETAILS:
Membership Fee Paid: Rs.__________/- vide cash/ cheque /draft No:__________
Drawn on -----------------------------------------bank dated-------------------------------payable at ----------------------------------------------------------.
Approved Membership Form Code:
M











Declaration by the Member
The above informations are true and I will abide by the rules and regulations of the society.
Full Signature of the Member:_______________________________________________
Date:_________________________________Place______________________________

RECORDS
APPROVED BY THE GOVERNING BODY DATED__________________________________________________________
Approval of the General Secretary/President:
APPROVED

Ledger No: Scroll No:


The Jadavpur Association of International Relations
FIRST YEAR MEMBERSHIP RECEIPT
Received with Thanks from Sri/Smt/Dr.________________________________________
of____________________________________________________________________a sum of Rupees__________________________________________________________
Only for the Annual Membership by cash/Cheque/Draft_No _________Drawn on___________
Bank _________Branch___________Dated_________________.
Membership Code:
M









Treasurer General Secretary