Condition Monitoring Society of India

Note: * Indicates Mandatory

Registration Form

Class of Membership^*

Institutional Type ^*

Full Name^*

Father's Name^*

Date of Birth^*

Nationality^*

Address^*

City/Town^*

District/County^*

State^*

Country^*

Zip/Pin^*

Phone^*

(O)(R)

Fax

E-mail^*

Members Profile

Designation ^*

Organisation ^*

Details of membership of other professionals Institutes/bodies

Details of awards/honours received

Brief Profile

Payment Details

Payment Mode ^*

Amount

DD/Cheque No

DD/Cheque Date

Name of the Bank

Declaration by Applicant

I certify that the information furnished above, is true to the best of my knowledge and belief. Also, upon my election as Member of Condition Monitoring Society of India, I agree to abide by the rules and regulations of the Society. I shall strive to promote the objectives and ideals of the society for the enrichment of field of Condition Monitoring.

Place^*

Date^*