Author: admin
Last saved by: Baluswami

Krishnamurthy Institute of Algology
9/2, Lady Madhavan 1^st Cross Street, Mahalingapluram, Chennai-600 034

E-mail: krishalg@gmail.com
APPLICATION FOR ASSOCIATESHIP/ANNUAL MEMBERSHIP/

INDIVIDUAL/INSTITUTIONAL

1	Name: 

2	Age and Date of Birth: 

3	Academic Qualifications: 

4	Profession: 
5	Address: 
6	 Mobile No.: 7588595492
Fax	:
E-mail    :
6. Interests in Algae (Teaching, Research, Collection, Hobby)

7. I wish to be enrolled as Member of the Institute (certificate from guide/

Head of the Department to be enclosed)

8. I agree to abide by the Laws of the Institute and any rules and regulations that might be framed from time to time according to the laws of the Institute.

9. I am enclosing a D.D for Rs…………………. Particulars of D.D./other

Date:

The following are the annual membership fee: Individual membership: Rs.3000/-, Institutional membership Rs.5000/- .  
Payments shall be made either by DD or by on line transactions and the details for them are given below:

1. DD:   DD to be drawn in favour of 
KRISHNAMURTHY INSTITUTE OF ALGOLOGY 
And sent by registered post to 
Mr.Vasudevan Krishnamurthy,
9/2 LADY MADHAVAN FIRST CROSS
MAHALINGAPURAM, CHENNAI 600 034

2. Electronic Money Transfer:
KRISHNAMURTHY INSTITUTE OF ALGOLOGY 
SB A/C NO. 048201000019395
IFSC   IOBA0000482
INDIAN OVERSEAS BANK
MAHALINGAPURAM BRANCH
CHENNAI 600 034

FOR OFFICE USE 
Application received on:
MEMBER Registration No…………..	Date:

Signature:
President	Treasurer	Secretary