MEMBERSHIP FORM

ENGLISH LANGUAGE TEACHERS ASSOCIATION OF INDIA (ELT@I)

An Affiliate of IATEFL, UK

English Language Teachers Association of India (ELTAI) D-54 Third Floor, Anandham

Apartments, #156, Sidco Nagar Main Road, Villivakkam, Chennai-600 049

Phone: +91-044-2617 2789 E-Mail: eltai_india@yahoo.co.in

                  BILASPUR CHAPTER                   Sr. No.

Visit us: www.eltai.net, www.eltaibilaspur.blogspot.com

Application for Membership

(Individual/Institution)

(Write in Capital Letters only)

Name of the Individual/Institution Dr/Mr./Ms./Mrs. _____________________________________________

Designation: ______________________________________________________________________________

Address __________________________________________________________________________________

_________________________________________________________________________________________

City…………………………………………………………State……………………………………………….

PIN CODE ______________________      Phone/Mobile No. ______________________ _____________   

E-mail. _________________________________________________________

Type of Membership sought:                         Annual/ Short Term/ Donor

Amount:          Rs:

Name and Address of the Institution, where working or worked last.

_______________________________________________________________________________

Signature                                                                                              (Sign of the Co-ordinator)

Date:                                                                                                              Bilaspur Chapter

Notes:

(1). Membership is valid from the date of receipt of the subscription at the office for the period desired.
(2). ‘The Journal of English Language Teaching’ (bi-monthly), published by the Association is sent free   

      to all members.

Membership is open to all teachers, research scholars, students and lovers of English (whether working or retired) and also educational institutions. There are three categories of membership offered-Annual, Short term (Three years) and Donor. Subscription rates are as follows:

Individuals
Annual:                                  Rs. 300/-. + Rs. 50/ for the chapter         = Rs. 350/
Short term (3 Years):         Rs. 800/-  + Rs. 100/ for the chapter       = Rs. 900/

Donor (10 Yrs):                   Rs. 2500/ + Rs. 500/ for the chapter       = Rs. 3000/   

Educational institutions                                                             
Annual:                                  Rs. 400/-  + Rs. 100/ for the chapter       = Rs. 500/
Short term (3 Years):         Rs. 900/-  + Rs. 200/ for the chapter       = Rs. 1100/

Donor (10 Yrs):                   Rs. 3000/- + Rs. 500/ for the chapter      = Rs. 3500/