GWALIOR ACADEMY OF MATHEMATICAL SCIENCES

Head Office: School of Mathematics Allied Sciences, Jiwaji University, Gwalior .

Application Form for Life/Donor Membership

Name

Date of Birth

Designation

Address (Official)

Phone Mobile

Email

Address (Residential)

Phone No.

Qualifications

Details of Research Publications

Areas of Interest

Type of Membership Life/Donor Rs2000/-(age upto 60 years)

Rs 1000/-(age above 60 years)

Any other Details

Date Signature

For Official Use

Received Rs. In cash/ by DD/Bank draft No

.

Dated towards Life/Donor membership of GAMS.

Date Signature

*Note-DD should be payable to Gwalior Academy of Mathematical Sciences, Gwalior

Fees for Life/Donor membership at present is Rs 2000/- up to the age of 60 years

And Rs 1000/- above the age of 60 years