APPLICATION FOR STUDENT MEMBERSHIP

STUDENT MEMBERSHIP FEES

Student Membership Fee for entire duration of UG, PG and Ph D programme is Rs. 1000/- (inclusive of GST) should be enclosed with the application form (effective from January 01, 2024) for each programme. If a student graduates with a degree and takes admission for a higher degree, she/he must pay fresh fees. Research scholar can use their contingency.

MODE OF PAYMENT

NEFT/RTGS/ECS DETAILS

Name of Payee	Indian Chemical Society A/C Convention of Chemist Fund
Bank Account Number	11152830968
Type of Account	Savings
Name of Bank	State Bank of India
Branch Name	Manicktala, Kolkata
Branch Code	01715
IFSC Code	SBIN0001715
PAN No	AAAAI1238H
MICR Code	700002062
IBAN No. or International SWIFT	SBININBB492
GST Number	19AAAAI1238H1ZV

Membership Details Payment Details Personal Details Further Information

Membership Details

Category of Membership Applied *

STUDENT MEMBERSHIP

Payment Details

STUDENT MEMBERSHIP FEES *

Transaction ID *

Payment Screenshot (Upload Screenshot - size 500KB) *

Personal Details

Prefix *

First Name (F) *

Middle name (M)

Surname/family name (S) *

ORCID id (for academics and researchers) If you do not have ORCID id, visit www.orcid.org and create it. It is a unique ID used globally for scientific writing and to avoid confusion in similarity of names. It is a sixteen-digit number with a hyphen after each 4 digits.

Date of Birth *

Gender *

Male

Female

Others

Select Nationality *

Personal Phone (10 Digit) *

Personal Email (Only gmail id is accepted) *

Residential Address *

City *

State *

Country *

Residential Pincode *

Aadhar Card / Pan No. *

Upload your photo * (Please upload an image less than 200 KB)

Further Information

Name of the College / Institute / University *

Name of the Principal / Director / VC *

College Phone *

College Email *

College Website *

College Address *

Town/City *

State *

Country *

Pincode *

Head of Department Name

Head of Department Phone

Head of Department Email

Upload Student ID-Card (Attach a PDF or JPG, JPEG file) *

Address of communication *

College / Institute / University

Home

Undertaking by the Student

I have provided the correct information in this application which is being authenticated by the College/Institute authorities.

Signature of the applicant with date (Upload signature - size upto 1MB) *

Certificate by the Head of Department and College Principal or Authorized Person

We have verified the information provided by the student, who is a bonafide student of this college/institute/university and joined as a student of B.Sc./M.Sc./Ph.D. programme. She/He is eligible to be a student member of the ICS. His roll number is …………… A copy of his identify card is also enclosed with this application.

Head of Department Signatory (Upload signature – size 50KB)

Principal of College/Institute/Authorized Signatory (Upload signature – size 50KB)