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Member Registration
Details |
| First
Name |
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| Last
Name |
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| Chapter |
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| Category
(
Details
) |
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| Organization |
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| Designation |
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| Qualification |
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| Date
of Birth |
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Official
Address |
| Street |
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| City |
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| State |
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| Country |
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| Zip
Code |
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| Phone |
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| Fax
No |
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Residential
Address |
| Street |
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| City |
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| State |
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| Country |
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| Zip
Code |
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| Phone |
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| E-Mail |
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| Mobile
No |
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Password
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Confirm
Password
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Whether
member of any other professional
Society |
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(1) |
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(2) |
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(3) |
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(4) |
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| Area
of Interest |
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| Professional
Experience |
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Payment Details |
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(1) Crossed Cheque/D.Draft should be in favour of
Society of Petroleum Geophysicists Dehradun.
(2) Cheque
Draft Should be sent to Secretary , SPG, 8th Floor, GEOPIC,
KDMIPE Campus, ONGC, Kaulagarh road, Dehradun-248195, Uttaranchal,
India.
Secretary,
Mr. S.K. Chandola Phone: 91-135-2796086 E-mail.: skchandola@spgindia.org
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| Cheque
/DD No
|
|
| Active |
Rs. 500/- |
| Life |
Rs. 3000/- |
| Associate |
Rs. 500/- |
| Institutional |
Rs.
25,000/- |
| NRI
and Other National |
US $30 |
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| Date |
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| Amount
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Bank
Name
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Declaration
I declare that
the above particulars supplied by me are correct to the best of my
knowledge. I am also fully aware of the fact that in the event of
any information being found incorrect or misleading, my membership will
be liable to be cancelled by the Society at any time.
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