-->

SPWLA India Chapter (A Chapter of SPWLA, USA) APPLICATION FORM STUDENT MEMBERSHIP

E-mail : spwla.india@gmail.com     Website : www.spwlaindia.org

To,

The Vice President (Membership)
SPWLA India Chapter,
103, 11 High, ONGC,
Mumbai – 400 017
Phone: 91 22 24088103, Fax: 91 22 24088183

Sir,
I desire/ continue to be Student Member of the SPWLA, India Chapter. My details are as follows:

Membership No:
Email address:
Password:
First name:
Middle name:
Last name:
Date of birth :
Mobile:
Course of study :
Expected date of course completion :
Institute/College with full address :
Major field of study/Area of Interest:
Mailing address :
Subscription details :
Cheque/DD NO:
Date:
Name of bank / branch:
Rs :

 

General Instructions:
1. Students must get the forms endorsed from any one of the faculty of the Institute.
1 .Subscription:
i) Initiation/ Renewal of membership : Rs.100
ii) Student Membership( Annual): Rs.100
2. Payment mode:
 (a) Cash
(b) Mumbai local/ at par Cheque or DD Payable to/ In favour of "SPWLA India chapter"

Subscription can also be made through RTGS/NEFT
Bank Acc. No. HDFC 00021450000082
IFSC Code HDFC 0000002