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Society For Failure Analysis Society For Failure Analysis Society For Failure Analysis Society For Failure Analysis

This document is an application form for membership in the Society for Failure Analysis. It requests basic contact information from applicants such as name, date of birth, occupation, academic qualifications, addresses, and professional experience. It also asks applicants to select their primary field of interest from options like strategic, power, foundry, and materials. Applicants must be endorsed by an existing SFA member and choose the chapter they want to be attached to. Payment details are also collected, including the amount to be paid based on the membership category of annual, student, or life member. Applicants must agree to the society's terms if elected for membership.

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39 views1 page

Society For Failure Analysis Society For Failure Analysis Society For Failure Analysis Society For Failure Analysis

This document is an application form for membership in the Society for Failure Analysis. It requests basic contact information from applicants such as name, date of birth, occupation, academic qualifications, addresses, and professional experience. It also asks applicants to select their primary field of interest from options like strategic, power, foundry, and materials. Applicants must be endorsed by an existing SFA member and choose the chapter they want to be attached to. Payment details are also collected, including the amount to be paid based on the membership category of annual, student, or life member. Applicants must agree to the society's terms if elected for membership.

Uploaded by

rameshtrk
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Application Form

Society for Failure Analysis


Society for Failure Analysis
C/O Regional Centre for Military
Airworthiness (Materials), CEMILAC
Kanchanbagh, Hyderabad 500058
Please applicable

1.
2.

Phone: 040-24340750; Fax: 040-24341827


E-mail: [email protected]
Website: www.sfaindia.org

Annual / Student Member

4.
5.
6.

Title: Dr/Shri/Ms
Name in Block Letters:
First
Middle
Name as you would like it on the card :
(max. 25 letters including spaces)
Date of birth
Fathers Name/ Husbands Name
Present Occupation /Designation and office address:

7.
8.

Academic & Professional Qualifications:


Home address:

9.
10.

Address for correspondence:


Professional Experience:

11.

Endorsement by SFA Member


Name

3.

12.

13.
14.

Life Member

Affix
Recent
Passport Size
Photo

Last

Phone:
Mobile:
Fax:
Email:
Phone:
Mobile:
Fax:
E-mail

office

Home

Membership No.

Signature

Primary Field of Interest: (please mark 1,2,3 in the in order of preference)


Strategic

Power

Foundry

Welding

Heavy industry

transport

Design &
Failures

Quality control

Petrochemical

Consultancy /
services

Materials and
manufacturing

Education

Name of the Chapter you intend to be attached_____________________________________________________


(Please refer to Chapters list)
Subscription details:
Payment should be made by cheque / DD favoring Society for Failure Analysis, payable at Hyderabad. Outstation cheques
not accepted.

Amount

Rs.

Bank Name
Category

15.

Cheque / D.D. No

Dated
Branch

Amount Payable

Annual
Rs 200/Student Member
Rs 200/- (Can be upgraded to Life Membership on payment for five consecutive years)
Life Member
Rs 1000/- (One Time)
Declaration by the applicant
If elected, I agree to accept to pay the prescribed yearly subscription, to abide by the Articles of Association of
the Society and to promote its aims and objects.

Signature of the Applicant


16.
Membership No.
Amount Paid (Rs)

Office Use Only


Date of Enrolment
Receipt No. / Date

Chapter

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