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✉ Membership Details

Profile Picture (JPG/PNG – Max 2MB)

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This photo will be used for your Membership ID card. Please ensure it's a clear, professional portrait.

Title

First Name

Middle Name (Optional)

Last Name

Email Address

Password

Phone Number (10 digits)

Residential Address

Verify Identity: Upload ID Photo (JPG/PNG – Max 2MB)

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Click to upload ID

Designation

Department

College / University

Professional Proof: Institutional ID Photo (JPG/PNG – Max 2MB)

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Click to upload ID Proof

State

Country

Select Membership Category

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Life Membership – Individual

Lifetime individual benefits

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Life Membership – Institution

Academic group affiliation

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Patron

Premium honorary status

💳 Payment Information

Bank Transfer Details

Account Name

Sample Association Name

Account Number

XXXXXXXXXXXXXX

IFSC Code

XXXX0XXXXXX

Branch

Branch Name, City

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Important: Transfer the exact amount to the bank account, and upload the success screenshot here for validation.

Upload Receipt Screenshot (JPG/PNG – Max 2MB)

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Upload Receipt

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