Form Lifetime Membership

Lifetime Membership Form

Title*

Dr./Mr./Ms.
Name*
CNIC*
Date of Birth:*
Date Format: YYYY slash MM slash DD
Gender:*
- Male
- Female
Highest Academic Qualification with Year of Award:*
Designation/ Post (Present/Last)*
Present for persons in service or last for retired persons.
Name of Organization/University/Department of Work (Present/Last)*
Present for persons in service or last for retired persons
Center/University Department/etc. of Work (Present/Last)*
Present for persons in service or last for retired persons
Date of Retirement:
Date Format: YYYY slash MM slash DD
Field of Specialization:*
Length of Service/Years of Experience:*
Description of Expertise*
Official Address:
Residential Address:*
Phone (Official/Residential)
Cell:*
Email:*
Please upload membership fee bank receipt image:
Lifetime Membership: Rs. 2100 Payment is to be made through crossed cheque in favor of Pakistan Nuclear Society or online deposit at NBP, IBAN: PK18NBPA1725004018982691 or in cash to be deposited with Finance Secretary PNS.
Please upload your recent photograph for Membership Card:
Date of Submission of Form*
Date Format: DD slash MM slash YYYY

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IBAN: PK18NBPA1725004018982691