Application form for IndianPim Membership

HIndi Title: 


Membership in Indian Network on Participatory Irrigation Management (IndianPIM) established under the patronage of Ministry of Water Resource, Govt. of India registered under Societies Registration Act XXI of 1860 on 10th February, 1998 at New Delhi (Regd. No. 32596 of 1998) is open to any individual or institution in the country involved in Research Training and Implementation of activities related to promotion or Participatory Irrigation Management (PIM), formation of Water User Association of improving irrigation utilisation and/or who has interest in irrigated agriculture. To become a member, please fill this form and send the form along with two recent photographs passport size and cheque of the prescribed amount in favour of Indian Network on Participatory Irrigation Management drawn on any bank at Delhi for through Demand Draft for outstation applicant to the IndianPIM, Room no.318 (Old Building) Central Soil and Material Research Station, Olof Palme, Marg, Hauz Khas, New Delhi-110016. Tel: 91-11-26569442/26865036 Fax: 91-11-26569442. E-mail: Your Membership will be confirmed after the receipt of membership fee.

Cheque/Draft No. _________________Bank _________ Branch _________________ Date _________________
First Name(s) ______________ Middle Name _________ Last Name ___________
Title/Designation ____________________________
Position/Organization _________________________
Mailing address ______________________________
Postel Code _______________________
Permanent address (Mandatory) ___________________
Postal Code __________________________
Male/Female __________ Office Tel: ________ Fax (with code)
Home Tel: (with code) _______________ E-mail__________________

Please describe your professional involvement/interest in irrigation management/participatory irrigation management and agriculture, horticulture, fisheries and rural development activities.

____________________________________________________________________ (Please attach extra sheet if necessary)

Type of membership for which you are applying:

i. Annual Individual Membership Rs. 350.00
ii. Lifetime Individual Membership Rs. 1100.00
iii. Institutional Membership Rs. 7500.00
Please Check you profession:
- Engineer
- Economist
- Social Scientist
- Environmentalist
- Agronomist
- Agriculture expert
- Soil Scientist
- Other (Please specify)

I desire to become a member of Indian Network on Participatory Irrigation Management (IndianPIM) and, if admitted, agree to abide by its Constitution and Rules framed there under and any amendments and/or alternations which may be made to it.

(Signature of Applicant)

साभार - इण्डियन नेटवर्क ऑन पार्टिसीपेटरी इरीगेशन मैनेजमेंट फरवरी 2008

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