DRAVIDIAN LINGUISTICS ASSOCIATION
AND
INTERNATIONAL SCHOOL OF DRAVIDIAN LINGUISTICS

 

 

Application For Membership 

(Regd.S.No.59 of 1971)

1. Name (block letters)   :       ___________________________________________________
2. Qualifications :       ___________________________________________________
3. Mailing Address :       ___________________________________________________
4. Type of Membership  :       ___________________________________________________
[ ]  Life Membership    [ ]   Institutional membership [ ]   Annual ordinary membership
Rs 1,500 (US$ 300) lump sum   or      Rs.15,000 (US$ 750) lump sum Rs. 500 (US$ 75)
Rs. 310 (US$ 62) in 5 equal installments
M.O/Cheque/DD No.    _____________     dt.   ______________  ( should be cashable at Thiruvananthapuram, Kerala, India. )
Post Office/ Bank through which
the Membership fee is remitted                ___________________________________________
Place  __________________
Date   __________________    

Signature  _______________

To    

The Treasurer
Dravidian Linguistics Association,
Kerala Panini Building,
St. Xavier's College P.O
Thiruvananthapuram  695 586
Kerala, India.


For Office Use

Receipt No.                : _______________  
Details of remittance    :    _______________  
Date of Membership    : _______________  
Treasurer/Secretary     :    _______________  

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