To,

Indian Society For Training & Tel: 26867710,26857157,26524509

Development E-mail : membership@istd.co.in
“Training House” Visit us at : www.istd.co.in
B-23, Institutional Area, New
Mehrauli Road, New Delhi-110016

INDIVIDUAL MEMBERSHIP FORM

(ANNUAL/LIFE)
Dear Sir,

I desire to become a Member of the Indian Society for Training & Development and accordingly provide the required
particulars as given on the reverse.

I agree to abide by the Memorandum of Association and Rules & Regulations of the Society as in force from time to
time.

1. ANNUAL MEMBERSHIP

(i) I enclose a cheque No. _________________dated________ drawn on____________________

for Rs 1300/- (Entrance fee Rs 300/- and Annual Subscription Rs 1000/- for the period April
201________to March 201_____ )

(ii) I enclose a cheque No. …………………..dated_________ drawn on ____________________

for Rs. 800/- (Entrance fee Rs. 300/- And Half Year subscription for Rs. 500/- for the period
October 201_____ March 201______)

2. LIFE MEMBERSHIP

I enclose a cheque No.___________________ dated____________ Drawn on________________________

for Rs 7800/- (Entrance fee Rs.300/- and Rs7500/- as Life Membership Subscription)

FOR LIFE MEMEBERS ONLY:

TWO COPIES OF YOUR RECENT COLOUR PP SIZE PHOTOGRAPHS ALONGWITH

SPECIMEN SIGNATURE IN BLACK INK ON PLAIN PAPER ARE REQUIRED FOR ISSUE
OF YOUR IDENTITY CARD.

3. ASSOCIATE MEMBERSHIP (18 years above and below 25 years)

(For those who are preparing for a career in the field of Training & Development and in some manner fall
short of the eligibility criteria for Membership)

I enclose a cheque No__________________ dated__________________ Drawn on __________________

for Rs. 700/- (Entrance fee Rs. 300/- And Annual subscription for Rs. 400/- for the period April 201_______
to March 201__________).
PTO
4. FOR SENIOR CITIZENS (60YRS AND ABOVE)

(i) I enclose a cheque No._________________ dated________ drawn on _____________________

for Rs 800/- (Entrance fee Rs 300/- and Annual Subscription Rs 500/- for the period April
201________to March 201_____ )

(ii) I enclose a cheque No. …………………..dated_________ drawn on ____________________

for Rs. 4050/- (Entrance fee Rs. 300/- And Rs. 3750/- as Life Membership Subscription).

P.T.O
 I certify that the above information is true to the best of my knowledge and belief. The Membership is liable
is to be cancelled if the information furnished is found to be incorrect.

Date______________ Signature______________________

(i) Please send A/c Payee Cheque in favour of “Indian Society for Training & Development, New Delhi”
(ii) Photocopy of this form can be used

The fee can also be paid through National Electronic Fund Transfer (NEFT) for which bank details are under:
1. Name of the Account : Indian Society for Training & Development
2. Name of the Bank : INDIAN BANK
3. Address : Mehrauli Institutional Area, Katwaria Sarai, New Delhi-16
4. PAN No. : AAATI0450L
5. NEFT/IFSC/RTGS Code : IDIB000M089
6. Account Number : 405039697
7. MICR Code : 110019018

Note: While remitting the payment, please do send the payment details advice to us for confirmation of the payment,
which is mandatory.

(Please type or write in Capital Letters)

Personal Particulars

1. Full Name: ________________________________________________________________________________

2. Address for Correspondence____________________________________________________________________

_________________________________________Pin_______________________________________________

Tel.______________________ Mobile ______________________ Email: ______________________________

3. Date of Birth: _______________________________________________________________________________

4. Gender (Tick only): Male Female

5. Academic Qualifications_______________________________________________________________________

6. Professional membership ___________________________________________________________________

7. Details of present appointment__________________________________________________________________

Position held________________________________________________________________________________

Name of company/Organisation_________________________________________________________________

Nature of Business_______________________________________________________________________

Office address_________________________________________________________________________

___________________________________________Pin______________________________________

Tel _______________________________________ Mobile: _______________________________________

Email: ______________________________________________________________________________________

FOR OFFICE USE ONLY

Entrance Fee received Rs____________ Date of Admittance by the

Subscription received Rs____________ National Council_______
For the year 20____________________ Membership No.__________________