Manohar Parrikar Institute for Defence Studies and Analyses
1, Development Enclave, Rao Tula Ram Marg, Delhi Cantt, New Delhi-110010
Tel: 91-11-26717983, Fax:91-11-26154192 Email: [email protected]
Please Affix
Application for Life Membership Your Photo
(to be filled in Capital letters) Here
To To
The Director General The Director General
Manohar Parrikar Institute for Defence Studies & Analyses Manohar Parrikar Institute for Defence Studies & Analyses
New Delhi-110010 New Delhi 110010
Sir, Sir,
I hereby apply for Life Membership of the Manohar I propose that…………………………..be admitted as
Parrikar Institute for Defence Studies & Analyses. a member of the Institute. He/She has been personally
known to me for about……………..years.
2. I undertake that, if accepted, I will observe the rules
and regulations governing membership of the Institute.
(Signature)
Yours faithfully ……………………………….
(Name in Block Letters)
(Signature) Membership No.
Date ……………….
Date ……………….
Place……………….
I second the proposal.
(Signature)
…….……………………….
Would you like your application to be considered for (Name in block letters)
Membership if it is not accepted for Life Membership
Membership No.
Yes No Date……………….
(Please tick as Applicable)
(For Office Use)
Approval/Date of enrolment……………………..Membership No……………………………
Membership form received………………………Subscription received on…………………
Particulars of the Applicant
1. Name ….…………………………………………………………………………..
(Beginning with Surname in block letters)
2. Present position/Last position ………………………………………………………………………...
held and name of the office …………………………………………………………………………..
3. Address
(a) …………………………………………………………………………………..
…………………………………………………………………………………..
Pin Code………………………………..Tel…………………………............
Fax No……………………………..……Email………………………………
(b) …………………………………………………………………………………..
…………………………………………………………………………………..
Pin Code………………………………..Tel…………………………............
Fax No……………………………..……Email………………………………
4. Nationality ………………………………………………………………………..
5. Date of Birth ……………………………………………………….. (dd/mm/yyyy)
6. Academic Qualification ………………………………………………………………………...
(Add separate sheet if necessary)
7. Experience/Interest
(a) Field of study, teaching/professional ……………………………………………………………………
(b) Membership details of
Academic/Professional organizations……………………………………………………………………
(c) Publications……………………………………………..……………………………………………………
(Add separate sheet if necessary)
8. Activities of the Institute in which interested (Please put mark)
Please indicate precisely the particular field of interest
(a) Publications
………………………………………………………
(b) Seminars and Conference
………………………………………………………
(c) Research Projects ….
9. Any other information that may be of interest………………………………………………………………………
10. If the Library facilities are desired: Please deposit Rs.5000/- as Security Fee refundable without
interest at the time of termination of Membership
Note:
1. Please hand over the filled application form with a passport size colour photograph to the AD (Admn).
2. The subscription fee for Life Membership is Rs. 6,000/- (one time), payable only on confirmation of
membership.
3. Please Attach proof of residential address.
4. Form should be proposed & seconded by the two Members or Life Members. Without proposed & seconded form
should not be accepted
