You are on page 1of 1
THE INDIAN INSTITUTE OF ARCHITECTS Prospect Chambers Annexe, Sth Floor, Dr D. N. Road, Fort, Mumbai - 400 001 "Tel = +91 22.2204 6972 / 2281 $491 / 2288 4805 » Fax » °91.22.2283 2516 spublication(@ gmail com /iiahol214@ mail com + Website : wow indiaainstituteofarchitects.com Email (10 BE FILLED IN WITH BLOCK LETTERS ONLY) To, ‘The Jt Hon, Secretary The Indian Institute of Architects Sa Floor, Prospect Chambers Annexe oe Dr, DIN. Road. Fort, “Murbai = 400 001 Subseription Payment Details: (Cash wil be accepred only av HA eee in Mum, against receipt) & 200/- (Yearly Subscription) ‘Add GST @ 18% on the amount payable cheque Mult cheue for ouston) DD. No tL LT jee TTT Te sr SE hint ce aa a Mute Name T Lea TT a Last Nome I it Jt 1 ange of my name Tahal tach the necessary legal dacments, ax required By WA.) An ease of Gender: C1Male/C Female Date of Birth + Contact Information: — Telephone: Email Res, Addeess I sae ala] ‘Year of ining Arhitetra Sates Name of Parents / Guardian : Adress Thave gone through the rules and regulations of The Indian Institute of Architects and shall abide by them. Signature of Stud SHRIVKUM.____ The above information is corect tothe best of my knowledge fs a bonafide student oF ou in (Proposed & Seconded by Members of ILA.) Stuaig in Clase Signature of Head of Institute

You might also like