Indian Concrete Institute

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Application For Membership

Fields marked with an asterisk * are mandatory.

ENTRANCE FEE
MEMBER CATEGORY	Rs.
Student Member	Nil
Individual: Annual Member	1000.00
Life Member	1000.00
Fellow Member (Conversion From Life)	5000.00
Organization: Annual Member	5000.00
Life Member	5000.00
Patron Member: Corporate / Organizational	5000.00
ANNUAL MEMBERSHIP FEE
Student Member	250.00
Individual Member	1000.00
Organizational Member	10,000.00
LIFE MEMBERSHIP FEE
Individual: Age < 45 yrs	6000.00
Age > 45 yrs	4000.00
Age > 60 yrs	2000.00
Organizational	40000.00
Corporate / Organizational	500000.00
Patron Members: Corporate / Organizational	1000000.00

I / We have read and understand the bye-laws of ICI. the membership fee of Rs.(Selected Above)

is sent by Cash / Cheque payable at Chennai / DD/ No drawn on

in favour of INDIAN CONCRETE INSTITUTE payable at Chennai, dated ( Annual subscription is for financial

year 1st April to 31st March of the respective year.) or Credit the Account of Indian Concrete Institute A/c. No. 000 101 208599

at ICICI Bank and attach Xerox copy of remittance challan

Name of Applicant ^*:

(In block letters)

Date of Birth ^*:

Sex :

Application dated :

Have you been member of ICI earlier For revival give old membership No

Address : Office*

Email ^*:

Pincode ^*: Tel ^*:

Residential ( in the case of organisational members name of

Prinicipal representative and residential address)

Email :

Pincode : Tel :

( Please indicate your preferred address for communication )

Kindly enroll me / us as individual / Organisational / student member of institute. My / our interests are listed below: ( fill in
squares with arabic numerals in order of preference.

Concrete Construction Training in Concrete Technology
Concrete Structal Designs Specialist Services
Research & Development Concrete Formwork and moduls
Concrete CompositesConcrete Equipment
Concrete TestingConcrete Reinforcement

Concrete Repairs
Precast Concrete
Prestressed Concrete
Others (Specify)

In the case of student members, Endorsement by Head of the Dept. of College / Polytechnic / Institute with address

Application endorsement by two members of ICI

Name

Member No

Address

Name

Member No

Address

Optionally you can give in brief, your qualifactions and experience with Concrete Technology and & Construction.

Qualification :-

Affiliation to other Associations/ Technical Institutes

Experience in Concrete Construction :-

Your Specialisation :

Your background and contributions to Concrete Technology & Construction.

Any other information relevant to Concrete Technology and Construction

* Life membership fee (individual) can be paid in three equal annual instalments.
Besides the above Life Membership fee, Entrance fee is also applicable to new members.
Send cheque/draft in favour of "Indian Concrete Institute" Payable at Chennai to
The Secretary General, ICI, Ocean Crest New#79 (Old #35) 3rd Main Road,Gandhi Nagar, Adyar, Chennai-20.