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122, T.V. Industrial Estate, S K Ahire Marg, Worli, Mumbai - 400 030. and
• Phone : 022-2494 3422 / 2493 4776 Fax : 022-2495 0543 Academic Institutes.
• Email : csi@bom2.vsnl.net.in
I hereby apply for membership for the under mentioned grade. On approval of Membership, I shall abide by the Constitution & Byelaws of the Society and the Code of Ethics.
ASSOCIATE MEMBER - (Tick any one ) (Individual) (Individual-Life) Nominee (Institution) Nominee (Academic Institution)
STUDENT MEMBER.
Kindly enroll me for the period Month 200 to Month 200
2. Postal Address (Block Letters) : (at which mail / other correspondence will be sent)
CITY PIN
STATE COUNTRY
PHONE With STD Code
3. Email :
4. Date of Birth D D M M Y Y
6. Qualification :
Degree Post Graduate Doctoral Others
P.T.O.
1
Computer Society of India
Region No. Chapter No. Name of Student Branch (for Student members) :
10. Would you like your name to be excluded from the membership lists if given for commercial purpose ? Yes No
2
Computer Society of India Connect to India’s Largest
122, T.V. Industrial Estate, S K Ahire Marg, Worli, Mumbai - 400 030. Body of IT Professionals...
• Phone : 022-2494 3422 / 2493 4776 Fax : 022-2495 0543 www.csi-india.org
• Email : csi@bom2.vsnl.net.in
You can Join CSI online http:// www.csi-inida.org Or by Fax : +91 - 22-2495 0543 Or
Complete this application and send with payment by post / courier to CSI, Mumbai.