APPLICATION FORM FOR ASSOCIATE MEMBER

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Category: (A) Institutional Members

Qualifier: Indian Government Bodies, Research and Academic Institutions

NO ANNUAL SUBSCRIPTION FEE APPLICABLE
DETAILS:
Name of Institution  
Director/Head of Institution  
Institution Address  
   
   
Telephone   Fax  
Email   Institution website www.
 
Human Resource:
Total No. of Employees        
Total No. of Scientists        
No. of Ph.D.   No. of M.Sc.   No. of B.Sc.  
Others    
 
Areas your Institution working in? (Please tick)
Agriculture
Aquaculture
Animal Health
Animal toxicity
Bioinformatics
Biopesticides
Biofuels
Bioremediation
Cancer
Cardiovascular		 Devices
Diagnostics
Drug Delivery
Drug Discovery
Enabling Technology
Engineering
Environmental
Enzymes
Food Technology
Funding		 Genetics & Genomics
Immunology
Infectious Disease
Neuroscience
Nanotechnology
Plant Biology
Proteomics
Patent Centre
Regulatory
Vaccines
Others (Please Specify)  
 
Would you like your Institute's website to be linked from ABLE's website?Yes     No
If 'Yes', please confirm the linkage and the referral e-mail
Website address www.
E-mail  

Please provide three names from your institution who should be included in the membership list of ABLE so that they receive all mailers and communication services:
Name   Title   Mailing Address   E-Mail
             
             
             
             

Signature		   Date    
Membership is effective upon receipt of completed application form. Renewal is automatic unless we receive a cancellation request.

Please return this form to:

ABLE Secretariat
No. 13, 2nd Floor, 4th C Block, 10th Main Road, Koramangala, Bangalore - 560034, India.

Telephone:
E-mail:
Website:

ableindia.org