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

INDIAN MATHEMATICAL SOCIETY
MEMBERSHIP APPLICATION FORM

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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 : ________________________________________________________________________


DD / cheque No. & Name of the bank (or date of bank transfer): ____________________________________________________________________

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The membership Fees are as follows :
(a) : Ordinary Annual or sessional Membership : Rs. 250/- (US $50/- for those residing outside India).
(b): Life Membership : Rs. 2000/- (US $500/- 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, Maharashtra, India.
The membership dues may be paid by a Demand Draft (or payable at par cheque or bank transfer, for bank details contact the Treasurer) payable to the INDIAN MATHEMATICAL SOCIETY at Aurangabad, Maharashtra.FOR STATE BANK OF INDIA BR. CODE IS 1716.