To,

Indian Society For Training & Tel: 49077807, 26857157

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 1534/- (Entrance fee Rs 300/- , Annual Subscription Rs 1000/- and 18% GST Rs. 234/-
for the period April 201________to March 201_____ )

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

for Rs. 944/- (Entrance fee Rs. 300/- , Half Year subscription for Rs. 500/- 18% GST Rs. 144/-
for the period October 201_____ March 201______)

2. LIFE MEMBERSHIP

I enclose a cheque No._______________ dated____________ Drawn on________________________

For Rs 9204/- (Entrance fee Rs.300/- , Life Membership Subscription for Rs. 7500/-and 18% GST Rs.
1404/-)

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)

(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. 826/- (Entrance fee Rs. 300/- , Annual subscription for Rs. 400/- and 18% GST Rs. 126/- for
the period April 201_______ to March 201__________).
 4. FOR SENIOR CITIZENS (60YRS AND ABOVE)

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

for Rs 944/- (Entrance fee Rs 300/- , Annual Subscription Rs 500/- and 18% GST Rs. 144/- for
the period April 201________to March 201_____ )

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

for Rs. 4779/- (Entrance fee Rs. 300/- And Rs. 3750/- as Life Membership Subscription and
18% GST Rs. 729/-).

5. FOR SPOUSE LIFE MEMBERSHIP

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

For Rs 5900/- (Life Membership Subscription Rs 5000/- and 18% GST Rs. 900/-)

6. FOR PHYSICALLY CHALLENGED PERSON (50% CONCESSION)

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

for Rs 944/- (Entrance fee Rs 300/- , Annual Subscription Rs 500/- and 18% GST Rs. 144/- for
the period April 201________to March 201_____ )

(ii) I enclose a cheque No______________dated_________ drawn on ____________________

for Rs. 4779/- (Entrance fee Rs. 300/- And Rs. 3750/- as Life Membership Subscription and
18% GST Rs. 729/-).

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.__________________