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The Indian Planetary Society

Astronomy & Science Centre, Planetarium, Solar & Stellar Observatories & Research Centre
Sub Centres at Halvad, Bhavnagar, Bhuj, Sangli, Shimla,
Mahuva, Mundra and Dabhoi

REGISTERED OFFICE

ADMINISTRATION OFFICE

B / 201, Vishnu Apartment, Near Babhai Naka,


L.T. Road, Borivali (W), Mumbai 400092
Maharashtra, India

A / 102, Nanddham Bldg A,


Opp. Shri Sagar Hotel, L.T. Road, Borivali (W),
Mumbai 400092, Maharashtra, India.
Tel. 022 - 28948678
Email: ips.science@gmail.com

Tel: 2898 8987,


Website: www.ipsindia.org

P RES IDE NT D R . J. J. R AWAL


Membership No: ____________

IPS No: ________________

Date: _______________

Membership in the Society keeps you in direct contact with your fellow-members, with all branches
of Science, Astronomy Astrophysics and their applications and with your professional colleagues.
Your participation in the society helps the advancement and communication of all branches of
Science, Astronomy, Astrophysics and Allied subjects and among scientists, as well. The activities of
the society which help youngsters, teachers and the society at large to progress in science, technology
and philosophy and cultivate scientific attitude and spirit to solve all kinds of problems of life and
leisure. Indian Planetary Society will also keep its members informed on all the socially relevant
issues.

Name ___________________________________________________

Gender _________

Address ___________________________________________________________________
__________________________________________________________________________
_________________________________________________________
Phone __________________

Fax ____________________

Education _______________________________________

Pin code ________

Email _________________
Birth Date ______________

Currently Active In _________________________________________________________


Amount ________________

Cheque No _____________

Cheque Date ____________

Bank Name & Branch _______________________________________________________


Reference _________________________________________________________________

___________________
Applicants Signature

________________
I-Card Issue Date

Members
Photo

Membership Types & Fees


Student Life Membership

Rs. 5050/-

Patron

Individual Life Membership

Rs. 10,050/-

Life Membership for Institutes

Family Membership (2 Adults +2 Children)

Rs. 30,200/-

Donor

Rs. 1,00,000/Rs. 75,000/-

Make crossed Cheque / Draft / Postal Order payable to The Indian Planetary Society. Please do not send
Money Order or give the amount in cash. Donations from all quarters will be appreciated.

P.S.: Submit 2 Colour Stamp Sized Photographs. Receipt will be issued later on.

Conditions Apply

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