ALL INDIA ASSOCIATION FOR EDUCATIONAL RESEARCH

Registered Under Societies’ Registration Act 1860

[Regn. No. 1597-180 of 1987-88, Bhbbaneswar]

N1/55 IRC Village, Bhubaneswar-751 015

e-mail:[email protected]

DONOR/ INSTITUTIONAL/INDIVIDUAL LIFE MEMBERSHIP APPLICATION FORM

Name in block letters:

[In case of individuals, surname first]

Designation/present position held

Official Address-

Pin: Tel. No. Fax: e-mail:

Residential Address-

Pin: Tel. No. Fax: e-mail:

Areas of Interest:

Experience in Guiding/ Conducting Research [period & nature]:

I agree to abide by the rules & regulations of the Association

Signature of Applicant

1. Donor : Rs. 5,000/-[Five thousand only]

2. Institutional:

· Category A[ Rs.10,000/-] covers as individual life members all faculty members 15-35 of the institution

· Category B [Rs.6,000/-] covers as individual life members all faculty members less than 15 of the institution

· Category C[Rs.2,000/-] covers as individual life members only the head of the institution

3. Individual: Rs.500/- [Five hundred only]

Mode of Payment:

Cash [ ] MO [ ] DD [ ] Cheque [ ] Cheque No. Date:

Dully filled in application form along with the membership fee to be sent to

Dr. Thilaka Suresh, Treasurer, AIAER

Reader, NKT National College of Education for Women, Triplicane

Chennai- 600 005

Drafts / Cheques to be drawn in favour of All India Assiciation for Educational Research

Payable at any bank at chennai

35/- to be added in case of outstation cheques

Receipt No. Date: Membership No.

General Secretary: Treasurer: