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Indian Chemical Society: Application For Membership

This document is an application form for membership in the Indian Chemical Society. It requests information such as the applicant's name, date of birth, gender, academic qualifications, professional experience, proposed by members, and payment details. The form notes that an applicant may be recommended for a different category of membership than what was applied for, and that the council's decision is final. It also lists the fees for different types of membership.

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Sharan Balaji
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92 views3 pages

Indian Chemical Society: Application For Membership

This document is an application form for membership in the Indian Chemical Society. It requests information such as the applicant's name, date of birth, gender, academic qualifications, professional experience, proposed by members, and payment details. The form notes that an applicant may be recommended for a different category of membership than what was applied for, and that the council's decision is final. It also lists the fees for different types of membership.

Uploaded by

Sharan Balaji
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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Indian Chemical Society

92, Acharya Prafulla Chandra Road, Kolkata-700 009, India.


Website: www.indianchemsoc.org E-mail: [email protected]
Phone: 91-033-2360 9497 Fax & Phone: 91-033-2350 3478

APPLICATION FOR MEMBERSHIP

Xerox copy of this form may be used
Read carefully the Rules in the annexed
sheet before filling the Form
An applicant may be recommended for admission to a category of membership different from the one
applied for. Admission to membership is made by the Council and its decision is final.

[ USE BLOCK LETTERS AND FURNISH DOCUMENTARY EVIDENCE OF ALL THE INFORMATION ]

Full name, (Surname first)
:
Date of Birth : Sex - Male / Female
Official Designation :
Office address
:


Residential address
:





Telephone No: (O) (R) (M)
Address for Communication
:



E-mail: Fax :
Academic qualifications
(Degree, university and year of
admission fromBSc onwards)
:



Professional Experience
:
Give a brief outline in an annexure within 200 words.(not applicable for Student Members ) stating
therein the most significant contribution in the field of specialization. Number of publications in
journals which are abstracted, articles, reviews, books, monographs, etc., along with a list of important
publications (up to 10 and stating the names of authors in each case) are to be enclosed.

Previous Membership No of ICS
( if applicable)
:

Membership Applied for*: Student Member/ Associate Fellow/Fellow/Benefactor/Patron
* Strike out which are not applicable




Proposed by (two ICS Fellows in good standing)

1. __________________________________ __________________________ ____________________

2. __________________________________ ___________________________ ____________________
Name Full Signature of the proposer Fellowship
-


To
The Honorary Secretary
Indian Chemical Society
92, Acharya Prafulla Chandra Road
Kolkata-700 009.

Sir,

I, the undersigned, do hereby engage that, if elected to the Fellowship/Associate Fellowship / Student Membership. I will
endeavour to promote the interests and welfare of the Indian Chemical Society and I will uphold its Constitution and observe its laws,
rules and regulations, and to the utmost of my power maintain its dignity as long as I shall continue as a Student Member/ Associate
Fellow/Fellow/Benefactor/Patron thereof.

I agree /do not agree to accept membership of a category different from the one applied for.

I agree to make payment of all appropriate dues on being intimated of the decision of my admission and I have noted that my
membership will be effective from the first day of the month immediately following the date of receipt of payment by the Society and I
shall be entitled to avail of the privileges of membership as provided in the Constitution and the Bye-laws of the Society.


Place:
____________________________________
Date : (Signature and full name of the applicant)




FOR OFFICE USE ONLY

Recommended /Not recommended for admission as Student Member /Associate Fellow /Fellow/Benefactor /Patron


______________________________
Date: Signature of the Membership Officer


Details of payment received and date of receipt : _______________________________________________________________

_______________________________________________________________


Admitted as Student Member /Associate Fellow /Fellow/Benefactor /Patron with effect from ...by the

Council of ICS at its meeting held on ___________________________________________



___________________________ __________________________________ _________________________________
Signature of the Accountant Signature of the Honorary Treasurer Signature of the Honorary Secretary






Membership Fees:

1. Life Membership Rs.4500/-
2. Ordinary Membership: (i) (a) Membership Fee Rs.350/-
(b) Admission Fee Rs.100/-
(c) Journal Rs. 200/ -
(d) Handling Charge (including postage) Rs.200/-
Total: Rs.850/- pe r annum (With Journal)

(ii) (a) Membership Fee Rs.350/-
(b) Admission Fee Rs.100/-
Total: Rs.450/- per annum (Without Journal)

Payments would be made by demand draft drawn in favour of Indian Chemical Society,
payable at Kolkata.

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