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Established : 1907
Registration No. S - 550, Delhi


Paste photo
(passport size) and
send a soft copy of it
with filled up 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 : _______________________________

E-mail and Phone(s): ________________________________________________________________________________________________________

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

Date : ____________________________________ ; Signature of the Applicant : _____________________________________

Name, Membership Number & e-mail ID of a proposer who knows the applicant: _____________________________________________________

Name, Membership Number & e-mail ID of a Seconder who knows the applicant: _____________________________________________________

DD/cheque no.& Name of the bank or Date & Transaction no. of online fund transfer (or a copy to be attached of cash deposit receipt if cash is
deposited) along with a soft copy of a passportsize photo in a separate mail to the Treasurer: ONLINE PAYMENT IS PREFERRED : ____________

The membership Fees are as follows (with effect from 01-01-2021):
(a) : Annual Membership: Rs. 500/-; and Sessional Membership: Rs.300/- ; (US $15/- for foreigners)
(b): Life Membership: Rs. 3000/- (US $150/- for foreigners, US$ 100/- for members of the Socitiies having Reciprocity arrangement with IMS and
US$ 50/- for those from the SAARC countries).

The completed Membership Application Form, alongwith membership Fees, may be sent to Prof. S. K. Nimbhorkar, Treasurer, Indian Mathematical
Society, C/O Dr. Mrs. Prachi Kulkarni, Ankur Hospital, Tilaknagar, AURANGABAD-431 004, Maharashtra, India.

The membership fees preferably be paid online. If online payment is not possible, then by a Demand Draft or payable at par cheque (payable to the
INDIAN MATHEMATICAL SOCIETY at Aurangabad, Maharashtra, India.) or by the cash deposit. The bank details are given below. For demand draft
drawn in favour of State Bank of India, note that its branch code for Aurangabad, Maharashtra, is 1716.

For the online fund transfer, the bank details are as under:

1) Name of the Account Holder : Indian Mathematical Society.
2) Name of the Bank : Punjab National Bank.
3) Branch Name and Address : Adalat Road Branch, Aurangabad - 431001.
4) IFSC Code: PUNB 0375900
5) Type of Bank Account : Savings.
6) Account No. : 0981000100312287

NOTE:The Indian Mathematical Society reserves the right to reject the application for the membership.