MEMBERSHIP FORM ALL INDIA ORIENTAL CONFERENCE 47th SESSION Notes: 1. Fill all the information in English Capital Letters. 2. Write only one letter in one box wherever provided. 3. Use a tick mark P wherever necessary. I know the aims and objects of the All India Oriental Conference. I wish to become a member of the AIOC . Please enroll me as a Patron Benefactor Life Member Full Member 1

Name of the Candidate: Surname: First name: Father's name/ Husband's name

2

Residential Adress:

3

State :

4

E-mail:

5

Mobile No.

6

Date of Birth in figures:

7

Academic Qualifications:

8

I shall present a Paper entitled

Pin Code

at the 9

Previous Sessions Attended

session

[1]

[2]

10 Papers accepted if any 11 The following are the classes of Membership: Patron Paying Rs. 5000/Life Member Benefactor Paying Rs. 2000/Full Member

Paying Rs. 1000/Paying Rs. 200/-

12 Payment Details: (i) Out station candidates pay by Demand Draft only. Outside Pune cheque will not be accepted. (ii) DD's payable at Pune to the General Secretary, All India Oriental Conference, Pune (iii) Please send different DD for Life Membership Fees and the session Fees. 13 DD Number.

Date

Amt.

Name of the Bank : Yours Sincerely Place : Date:

Page 1 of 2

(Signature of the Applicant)

Certificate by the sponsor I know, and have great pleasurer in sponsoring his/her application for Membership of the All India Oriental Confrence.

Signature Name Designation Address

Applications for membership shall have to be sponsored by a Professor or Head of a University Department or some other University authority or by State or Union Government or by a statutory body or by a well-established Research Institute or by one who is or has been an office bearer of the Conference. This condition is, however, not applicable to persons who have attended three or more sessions of the Conference and have submitted a paper or papers which has or have been accepted at any one or more of these sessions, or to persons who are or have been office bearers of the conference

BOOK-POST To,

FROM : GENERAL SECRETARY ALL INDIA ORIENTAL CONFERENCE Head Office : Bhandarkar Oriental Research Institute, 812, Shivajinagar, Law College Road, Pune – 411 004. Ph. No./Fax: 020-25656932/Website : http://aioc.in E-mail – [email protected] Page 2 of 2