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Application for Individual Membership

(Non-Deposit user)
1. Name (In Capital letters) :

2. Age :

3. Year in which studying :

(Post Graduation/Research)

4. College /Institution :

5. Residential Address :

6. Payment by Cash(Code No 61/617) :

One day Rs. 50.00


For three days Rs. 100.00
For one week Rs. 200.00
For one month Rs. 400.00
For three months Rs. 600.00
For one year Rs.2000.00

I shall abide by the rules and regulations of the Library, Indian Institute of Management
Bangalore.

Signature of the Applicant


Date:

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