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INTERNATIONAL UNION FOR SCIENCE COMMUNICATORS
VIDNYAN BHAVAN,V.N.PURAV
MARG, SION-CHUNABHATTI, MUMBAI 400022.
PHONE 91-22-5224714, 91-22-5226268, FAX 91-22-5226268
E-Mail mavipa@vsnl.com
(Please use Capital
letters)
I/We am/are in agreement
with IUSC’s objectives mentioned in IUSC’s rules and byelaws
item 1.1 and shall agree with the statement of aims and objectives mentioned
therein.
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I / We wish to become
annual member.( Life membership is not available ) |
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Name in full (Individual / Institution) |
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Address |
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Phone nos. |
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Fax nos. |
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e-mail |
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Web site |
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Education / Profession (Individual) |
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Work Area (Institution) |
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Institution |
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Membership Category
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Full Member (Category &
No. of Units of Contribution)
Contribution is USD 200 per Unit of Contribution or equivalent Rupees
in India, annually |
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Associate Member (Category
& No. of Units of Contribution)
Contribution is half of units of contribution x USD 200 annually |
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Individual Member USD
20 annually |
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Note. Cheque facility for only Mumbaiites
/ Demand Draft for outstation people and for out side India people. Cheques
and Demand Drafts in favour of 'International Union for Science Communicators'
Enclosures required
- Bio-data for Individuals /Information
Brochure for Institutions together with latest Annual Report.
- Passport size coloured photograph
for individuals.
Date ____________________________
Signature ____________________________
Rubber Stamp in case of Institution
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