New Member Registration

Type of Membership

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Name

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Specialization

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Designation or Position

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Name & Address of Employer

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Mailing Address

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State

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City

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Telephone Number

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Email Address

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Date of Birth

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Nationality

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Qualifications:

Academic Qualifications

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Technical Training etc.

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Membership in other Societies

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Professional Experience

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Old Membership No., If any

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Member Photograph

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Signatures

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