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Indian Mathematical Society

Established : 1907
Registration No. S - 550, Delhi
http://www.indianmathsociety.org.in

INDIAN MATHEMATICAL SOCIETY
MEMBERSHIP APPLICATION FORM
_______________________________________________________________________________________________________

Full Name (BLOCK LETTERS) : ______________________________________________________

Date of Birth: _________________________________ Nationality : ________________________

Educational Qualifications: ________________________________________________________

Areas of Specializations, if any : ____________________________________________________

Present Position: _________________________________________________________________

Office Address, if any : _____________________________________________________________

_________________________________________________________________________________

Address for Correspondence: _______________________________________________________

_____________________________________________________ PIN : _______________________

Phone(s): ________________________________________________________________________

E-mail: __________________________________________________________________________

Type of Membership desired : ORDINARY / LIFE*
* Strike off whichever is not applicable.

Date : ________________________ ; Signature of the Applicant : ______________________________________

Name, Membership Number & Signature of the Proposer : _________________________________________________

Name, Membership Number & Signature of the Seconder : _________________________________________________


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The membership Fees are as follows :
(a) : For Ordinary Annual Membership : Rs. 200/- (US $100/- for those residing outside India).
(b): For Life Membership : Rs. 2000/- (US $1000/- for those residing outside India).
The completed Membership Application Form, alongwith membership Fees, may be sent to
Prof. S. K. Nimbhorkar, Treasurer, Indian Mathematical Society, Department of Mathematics,
Dr. Babasaheb Ambedkar Marathawada University, AURANGABAD - 431004 (MS), India.
The membership dues may be paid by a Demand Draft payable to the INDIAN MATHEMATICAL SOCIETY at Aurangabad.