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Indian Women Scientists' Association

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INDIAN WOMEN SCIENTISTS' ASSOCIATION

Soc. Regd. Act 1860 Regd. No. Bom. 193.73 GBBSD dt. 13/6/73

Bom. Pub. Trust Act 1950 Regd. No. F-2931 (Bom.) dt. 19/7/73

Categories of memberships:

Life Member

Membership is open for all women with a science degree; minimum requirement is a graduate degree or diploma

holders in all disciplines of basic and applied sciences. Payment of life membership fee is mandatory.

Member

Graduates and diploma holders in all disciplines of basic and applied sciences, who have taken membership

for one year only.

Associate Members

Those women interested in scientific activities and with a scientific temperament; degree in science is not essential.

Honorary Members

Women scientists of National & International repute; they will be invited to become Honorary members of IWSA.

Subscription :

Admission Fees

Rs. 50/- for all categories of members.

Life Member

Indian Rs.2000/- Abroad200$

Regular Members

Indian Rs. 200/-per year

Associate Members

Indian Rs. 200/- per year

N.B.

1. Any change in address must be communicated immediately to the IWSA Office.

2. All outstation cheques must include Rs.50/- as bank service charges.

3. Cheques should be drawn in favour of "Indian Women Scientists' Association".

(Application for Membership)

To,

The Secretary,

IWSA,

Sector-10A, Plot 20,

Vashi, Navi Mumbai - 400703.

I am interested in the objectives of IWSA and desire to become member /associate member / life member of the Association.
I enclose herewith Rs._________(cash / cheque drawn on _________________________________________________) as membership contribution.

(Membership Form)

Membership No. ________

INDIAN WOMEN’S SCIENTISTS’ ASSOCIATION

PLOT NO. 20, SECTOR 10A, VASHI, NAVI MUMBAI-400703.
Tel No. 022-276618.6, 27662136 · Fax No.91-022-27653391.
iwsahq@gmail.com · www.iwsa.net.

APPLICATION FOR MEMBERSHIP

Category of Membership applying for [Please (P)]:

£ Honorary Member £ Life Member £ Associate Life Member

£ Associate Member £ Member

1. Applicant’s Name:

Main Name/Surname/Last Name [used for alphabetical listing]

Rest of the Name/ First and Middle Name [used as initials]

2. Date of Birth

Date

Month

Year

3. Job Title / Designation:

4. Organisation / firm working for (presently or in the past):

5. Mailing Address:

City

Pincode

State

Country

Phone(off)

Residence

Fax( off)

Cell No.

E-mail

6. Academic Qualifications:

Degree Obtained	Name of University/Institution	Year	Major Field of Study

7. Professional Experience (Technical / Science/Administrative/Managerial:

Name of Organization	From	To	Title/ Description

8. Payment Details:

Amount Rs……….. Cash/DD/Cheque No. ……………………. Dated …/…/………
Drawn on [Bank/ branch] ………………………………………………………………….
(Payment should be drawn in favour of “Indian Women Scientists’ Association” & payable in Mumbai;
please add Rs. 20/- for outstation cheques)

9. Declaration by Applicant:

I hereby declare that I shall abide by the rules and regulations of the IWSA and endeavour to maintain the
professional integrity that is expected of me as an IWSA member, if admitted.

Date: ..... /…. /……… Signature……………………………………

10. Introduced by IWSA Member

I, ………………………………………………………… know Dr./ Ms ………………………………………….
For ………. Years and recommend her for membership of IWSA.

Name:

Address: ___________

___________________
Signature of the IWSA Member

Date: ..... /…. /………

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