ISHRAE
ISHRAE
ISHRAE
Headquarters: 502, DDA Building, District Centre, Laxmi Nagar, Delhi - 110092 (India) Telefax: 011 - 2254 0537 Tel.: 011 - 4300 1814 Email: ishraemembership@airtelmail.in Website: www.ishrae.in
Town / City
Full Member
Associate Member
Affiliate Member
Student Member
(First)
(Middle)
(Surname)
/
dd/mm/yy
Business
Home
Tel. Landline with STD PIN code Home Address Tel. Mobile Tel. Landline with STD
H S I E R A
Yes
No
Membership Fee
Registration Fee Annual Fee Total Full Member / Associate Member / Affiliate Member Rs. 2250/Rs. 2250/- (for 3 years @ Rs. 750/- per annum) Rs. 4500/Student Member NIL Rs. 350/Rs. 350/-
Account payee Cheque (for Outstation - DD only) to be drawn in favour of ISHRAE Headquarters Payment Details Cheque/Draft Number: For Online Payment: Visit at www.ishrae.in Amount: Drawn on Dated:
Transaction ID
Amount:
Dated:
CERTIFICATE BY APPLICANT I hereby certify that the information provided above is true and correct to the best of my knowledge and if admitted, I will abide by the constitution and the rules & regulations of ISHRAE.
Date:
Applicants Signature:
Admit
Reject
H S I E R A
Annexure