The Indian Political Economy Association

Name

Ms.Mr.Dr.Prof.

Address

Mobile No.

Fax No.

E-mail

Institutional Affiliation

Designation / Occupation

Areas of interest

Type of membership

AnnualLife

I have read the Aims and Objectives of the Association and I accept them and shall endeavor to contribute my best towards their realization.

Date

Place

Payment Details:
(Fees: Rs. 100 for the Annual Membership and Rs. 1500 for the Life membership)

Enclosed: Cheque / Draft No.

Dated

Bank Branch

Amount

For the Year

I Agree