Apply for IPSA member

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Title

1. Full Name (Capital Letters)

First

Last

2. Father Name

3. Sex

4. Qualification

5. Date of birth

6. Sex

7. Occupation

8. Designation

9. Postal address

10. City

11. Pin code

12. State

13. Mobile

14. Whatsapp

15. E-mail

16. Membership Type

17. Payment details

I hereby certify that all the details mentioned are true and correct to my knowledge.

I have read and understood all the information pertaining to IPSA membership and its payment terms and conditions.

I have enrolled as a student as per college records and submitted the duly signed studentship form by my supervisor (for student concessional membership)

Duly signed certificate of student membership

Passport photograph (jpeg)

Upload proof of payment (jpeg)

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