THE MADRAS LIBRARY ASSOCIATION

Ground Floor, LLA Building, 735 Anna Salai, Chennai 600 002 eMail: madraslibraryassociation@gmail.com
Membership Fee Student * Rs. 500/Life Rs. 1000/Institutional Rs. 3000/* Students need to upgrade their membership by paying additional Rs. 500/- once their education are over.

Application for Membership

(Please fill the form in CAPITAL LETTERS)

I hereby apply for admission to the STUDENT / LIFE / INSTITUTIONAL Membership and, if admitted, shall abide by the constitution and Byelaws of the Association. Name and Initial(s) Title Nationality Date of birth Employment details Name of the Organization : Designation Address : : : : Ms. / Mr. / Dr. / Prof. : : (YYYY-MM-DD) Sex: M / F

Educational qualification :

PIN Code

Telephone/Mobile No(s) : E-Mail : __________________________________________________________________

Communication Address :

PIN Code

Telephone/Mobile No(s) : Payment details Cheque / DD No. : __________________________ Date: __________________________ Name of the Bank: __________________________ Amount (Rs.): ___________________ Signature of the Applicant: ___________________________________________________ Place: ____________________________________ Date : __________________________ Note: The Demand Draft or Local Cheque should be in favour of THE MADRAS LIBRARY ASSOCIATION and send along with the Application to Dr. G. Krishnamoorthy, University Librarian, Anna University, Chennai 600 025.