PROFORMA

(Recommendation for Life Membership)

Name of the Applicant (Life Member) ______________________________________________

Designation _______________________________________________

Name of Institute / College / Office / Orgn. _______________________________________________

_______________________________________________

_______________________________________________

It is certified that the candidature of the above applicant, who has applied for ISTE life membership is correct to
the best of my knowledge and belief. I recommend him for ISTE Life membership.

Signature of Recommending Officer ________________________

Name ________________________________________________

Designation ___________________________________________

Address ______________________________________________

_____________________________________________________

Email ________________________________________________

ISTE Life Membership Number (If Available) _________________

Date: ________________________________________________