APPLICATION FOR STUDENT MEMBERSHIP
  Note:
   • Please ensure you have filled in all details in the application form.
   • A filled in form will be sent to your email. Take a printout of the document, and send the copy along with DD/payment details to address mentioned in contactus page
   • If you are applying for Student member send letter of recommendation from your head of the department or institute.
   • YOUR APPLICATION WILL BE PROCESSED ONLY AFTER THE RECEIPT OF DOCUMENTS, PAYMENT AND VERIFICATION.
   • All fields highlighted are compulsory.
  Personal Information: Date:  
Name:
    Firstname Lastname Surname
Date of Birth:(DD/MM/YYYY)  Age:  Gender:Male   Female
Mailing Address:
City: State:
Country: Pin Code:
Phone No:  Mobile:   E-mail:
Same as Mailing Address
Permanent Address:
City:  State:  Country:  Pin Code:
Phone No:  Mobile:  E-mail:
  Upload Photo:
     Choose a Passport size photo:
  Educational Qualification:
Degree Year of Admission Name of the Institute
(Please enter only the institutes name)
Upload ID Card
BASLP
  Upload RCI recognition of your Institute for the period of study (JPG format):
     Choose the document to upload:
  Recommended By:
S.No. Membership No Name Email Address
1.
2.
   Note: One of the Recommender should be your Head of the Department/Institute's Email Address.
  Payment Details:
DD Number:  Date:  Payable at:  Amount:
Online/cash deposit @ BoB details only:
I have read the byelaws of the association. I hereby promise to abide by the byelaws of the Association.
Place: Signature:
Date: (typing your name here is your signature)