ELTAI Application for Membership (Individual/Institution)

Name of the Individual/Institution ________________________________

Address _______________________________________________________

City ___________________________________________________________

State _________________________________________________________

PIN CODE _____________________________________________________

Ph: ______________________ E-mail. _____________________________

Fax: __________________________________________________________

Type of Membership sought: ____________________________________

Amount sent: __________________________________________________

Mode of payment: Demand Draft.

Details of Draft/Cheque sent:

No:
Bank:
Dated:

(To be drawn in favour of ‘The English Language Teachers‘ Association of India‘.)

In the case of Individuals only.

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

Place:
__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

Signature.

Date:

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.