othercollaborators
 

  APPLICATION FORM MEMBERSHIP



 
 1.    Type of Membership desired :  
 2.    Name :  
 3.    Address :  
 4.    Phone:  
        Office:  
        Res:  
        Mobile:  
 5.    E-mail  
 6.    Website  
 7.    Occupation/Designation
         
 8.    Institutional/Affiliation
         
 9.    Qualifications :  
 10.    Professional Experience :  
 11.    Professional/Research interests :  
 12.    Membership of any other Association,
          Society Academy etc. :  
 
       I hereby certify that the information given above is true to the best of my
knowledge. I fully subscribe to the aims and objectives of the AHI and undertake to
abide by the rules and regulations of the Association in case I am declared a Member/Institutional Member/Life Member of the Association.  





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