Robotic Society of RUET

Collaboration and Innovation for Better Future

RsR
Robotic Society of RUET

MeMbership ApplicAtion Form Full Name: Nick Name: Department: Place of Occupation/ Occupation: Present Address: Permanent address:

Date of birth: Roll:

Photo

. Hobby: Field of Interest: (Fill the box) Mechanisms design Control Web page design Drawing and design Contract no: Office: Mobile:

Programming Circuit design

Networking Others

Residence: E-mail:

I hereby ascertain that I will make every effort to discharge my duties and responsibilities according to the purpose and ideology of the constitution. Signature & Date

RSRProposor: (a) Name: (c) Signature of recommended: Annual subscription: is accepted approved as a member. (b) Post: (d) Date Application from the day:

Receipt for Applicant Membership fee (with application) Taka by bank receipt is accepted. Receipt no.

RSR-

RsR
General Secretary President of RSR

Robotic Society of RUET