MEMBERSHIP FORM

THE JADAVPUR ASSOCIATION OF INTERNATIONAL RELATIONSMembership FormFOR TEACHERS/PROFESSIONAL/STUDENTSTitle: 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:MDeclaration by the MemberThe above informations are true and I will abide by the rules and regulations of the society.Full Signature of the Member:_______________________________________________Date:_________________________________Place______________________________RECORDSAPPROVED BY THE GOVERNING BODY DATED__________________________________________________________Approval of the General Secretary/President:APPROVEDLedger No: Scroll No: The Jadavpur Association of International RelationsFIRST YEAR MEMBERSHIP RECEIPTReceived 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:MTreasurer General Secretary