INTERNATIONAL COUNCIL ON LARGE ELECTRIC SYSTEMS

TO BE SENT TO NATIONAL COMMITTEE (i.e Central Board of Irrigation and Power)

MEMBERSHIP APPLICATION FORM for the year 2012

Please fill in the column of the relevant MEMBER CATEGORY.

INDIVIDUAL MEMBER I
COLLECTIVE MEMBER I COLLECTIVE MEMBER II
Administrative bodies, scientific and technical organisations, Universities, Educational Bodies only.
INDIVIDUAL MEMBER II research institutes, public or private Companies industrial
and/or commercial.
(Young Member under 35 years)

Family Name NAME of COMPANY NAME of UNIVERSITY

.. ......... ..........
Forename ..... ......
...
Position, Dept. Person or Department to receive ELECTRA journal. Person or Department to receive ELECTRA journal .
......... ...........
Company, Organisation ..... .......

Full Address Full Address

Full Address ...... .
....... .........
... ..... ...
... ..... ...
TEL ........
TEL Mobile no. TEL ........
Mobile no.
FAX . Mobile no.
FAX
E-Mail.. FAX
.
E-Mail...
Year of Birth .. E-Mail......

The details for bank transfer

Membership fee in India Rs. Is as below :
Vender Name The Committee for International Conference on Large High Voltage Electric Systems (CIGRE) India
1 Collective I Rs. 57,000/-
2 Collective II (Universities & Rs. 18,000/- Bank Name & Branch ICICI Bank Limited/ Malcha Marg Shopping Centre
Regulatory Commission) Branch Address 16/48, Malcha Marg Shopping Centre, Chankyapuri, New Delhi -110021. Ph.No.41680133-34-35
3 Individual Rs. 5,500/-
IFSC code of branch ICIC0000346 MICR No. : 110229052 Account No. : 034601001054
4 Young - below 35 years of age Rs. 2,750
Type of account Special Saving Account PAN No. : AAAAZ0260A
Fee can be paid through cheque/ DD in favour of
CIGRE India or through bank transfer