Enrol as member

MEMBERSHIP FORM

Name

Father’s / Husband’s Name

Select Gender

Date of Birth

Nationality

Present Address

Pincode

State

Phone No.

Mobile No.

Present Occupation/

Position

Field of Expertise

Registration number of VCI

Academic Qualifications

Sr. no.

Degree

Year

University

Area of specialization

Sr. no.

Degree

Year

University

Area of Specialization

Sr. no.

Degree

Year

University

Area of Specialization

Sr. no.

Degree

Year

University

Area of Specialization

Sr. no.

Degree

Year

University

Area of Specialization

Sr. no.

Degree

Year

University

Area of Specialization

Payment of the life Membership fee of Rs 4000/- (Four Thousand Only) will be made online (NEFT) mode and the receipt of the same should be sent to Email: aizwv06@gmail.com along with the copy of the registration form. Bank account details for payments are provided below:

Name of the Bank	State Bank of India
Branch Name	Indira Nagar (Bareilly) Opp. Tara Talkies, Bareilly,Bareilly Dist, Bareilly, Uttar Pradesh 263005
Branch Code	8063
Account Holder Name	Association of Indian Zoo & Wildlife Veterinarians
Account no.	30765234561
IFSC	SBIN0008063
MICR	243002009

Payment proof

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