Society For Educational & Scientific Research
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Membership Application Form

Membership Application Form



Please tick on the appropriate column

SESR MEMBERSHIP

INDIAN NATIONALS

NON-RESIDENT OF INDIA AND FOREIGN NATIONALS

SESR Fellow member

Rs. 7000

USD 250

SESR Life member

Rs. 5000

USD 200

SESR Annual Member

Rs. 3000

USD 150

SESR Corporate Member /
Patron Membership

Rs. 20,000 for lifetime
Rs. 10,000 for five years

USD 500 for lifetime
USD 400 for five years

SESR Institutional Member

Rs. 15,000

USD. 500


MEMBERSHIP DETAILS:

Title

:
*

First Name

:
*

Last Name

:
*

Upload your (passport size photo)

:
*

Job Title

:
*

University/Institute/ Company

 :
*

Email

 :
*

Website

 :
*

Telephone: (O)

:
*

Telephone: (R)

:
*

Mobile

:
*

Fax

:

Date of birth

:
*

Qualification

:
*

Address for the correspondence

 
*

Suburb

:
*

State

:
*

Postcode

:
*

Country

:
*

Do you hold any fellowship

:
Yes / No
*

Specify

:
*

Method of Payment

:
Direct deposit / Online transfer
*

Upload payslip / Bank transfer details

:
*

Upload your profile

:
*

How did you know about SESR

:
Website
Facebook
Through any member please specify
*
By my signature below, I certify that to the best of my knowledge, the information provided in all parts of my application is accurate and complete. I understand that final approval of my application is dependent upon my eligibility.

(NAME IN BLOCK LETTERS) hereby express my wish to be enrolled as above showed member of Society or Educational & Scientific Research (SESR)

First Name

:
*

Last Name

:
*

Date of Signature

:
Month / Day / Year
*

Enter Code

:
*

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