Membership Application Form

We/I agree to abide by the Constitution and the Rules and Regulations of the Society.

We/I enclose a sum of Rs.__ in full payment of our/my entrance fees and subscription fees for the first year.

Chapter
Each Chapter will provide the platform for PRSI membership in the respective region

Please enroll us/me as a member of the Public Relations Society of India.(required)

Name (BLOCK LETTERS)

NATIONALITY

DATE OF BIRTH (YYYY-MM-DD)

ACADEMIC QUALIFICATIONS

PROFESSIONAL QUALIFICATIONS (PR/MASS COMM/JOURNALISM/ADV.)

COMPANY NAME

DESIGNATION IN COMPANY

NUMBER OF YEARS EXPERIENCE

WORK RESPONSIBILITIES

COMPANY ADDRESS

TEL NO./MOBILE/FAX NO.

E-MAIL

RESIDENTIAL ADDRESS

MEMBERSHIP IN OTHER PROFESSIONAL ORGANISATIONS

TOTAL NUMBER OF YEARS EXPERIENCE IN PUBLIC RELATIONS

ACTIVITIES WITH DETAILS OF FUNCTIONS PERFORMED

Cheque No

Amount

Bank

Date (YYYY-MM-DD)

PROPOSED BY

SECONDED BY

Recommended in the Category of :

LIFE/PROFESSIONAL/ASSOCIATE/CORPORATE/STUDENT MEMBER
Recommended by the Chapter : Signature __________________

Date __________________

APPROVED/NOTE APPROVED

MEMBERSHIP CATEGORY : ____________________

MEMBERSHIP NUMBER : ____________________

Approved by the National President Signature : ____________________

Date : ____________________

Download Membership Application Form