Annual Membership: Rs. 500/- U.S. $ 30/-                                                                                   Life Membership: Rs. 5000/- U.S. $ 300/-

Name _____________________________________________________________________________________________________    

Last                                            First                                        Middle

Professional Address : ________________________________________________________________________________________  

__________________________________________________________________________________________________________    

Mailing Address (if different) : __________________________________________________________________________________ 

__________________________________________________________________________________________________________    

Telephone. No. ________________________    Mobile No. _____________________ E-mail  ___________________________ 

Present position or status _____________________________________________________________________________________

Academic qualifications ______________________________________________________________________________________

Specialization ______________________________________________________________________________________________

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Relationship of your work to the general field of Human Ecology : ______________________________________________________

Payment by Cheque/Draft No. __________________________________        Dated ________________________________________

Drawn in (name of the Bank) of _______________________________________________________________________________

_________________________   _______________________________________________________________________________

       (amount in figures)                                                                             (in words)

______________________                                                                                         __________________

(Signature)                                                                                                                                               (Date)

For Official Use:                      Membership No. _______________                       Date_________

Address for correspondence: M. K. Bhasin, Secretary General  (Retired Professor and Ex-Head, Department of Anthropology, University of Delhi, Delhi 110 007, India) B-2, South City II, Gurugram 122 018, Haryana, India

E-mail: mkbhasin17@gmail.com