INDIAN INSTITUTE OF BANKING & FINANCE
ORDINARY MEMBERSHIP APPLICATION FORM
(please see instructions before filling up the form)
Membership No.
To,
Chief Executive Officer
Indian Institute of Banking & Finance
(to be allotted by the Office)
Dear Sir,
I, as an employee of the bank/financial institution mentioned below, offer myself for being admitted as an Ordinary Member of Indian
Institute of Banking & Finance.
1)
Full Name Mr./Ms./Mrs. :
(As Recorded with Employer)
2)Office/Residential Address for communication (DO NOT REPEAT NAME)
STATE
PINCODE
3)
Nationality
4)
Date of Birth : Day :
Month :
COUNTRY
Year :
5) Sex (M/F)
6) Qualification: (a) Educational…………………………….…………. (b) Professional (such as LLB,C. S., C. A.,MBA., etc.):
………………………...………
7) Bank / Institution working
with:……………………………………….…………………………….Branch……………………………………………
Designation……………………………
8)Date of Joining Bank / Institution: Day :
Staff No.…
Month :
9) Phone: …….……….….. Fax:….……………. Country Code :……….…
email…………….………………………
Yeyear :
City Code………….:
10)Draft/Payorder Details:
Draft No.
Draft Date
Drawee Bank and Branch
Applicant’s one
colour Photograph
of
1 ½” x 1 ½” size
duly signed across
by applicant
(to be stapled here)
Draft Amount
11)DECLARATION:
a)
b)
I hereby declare that all the information given in this application is true, complete and correct. I understand that in the event of
any information being found false or incorrect subsequent to allotment of membership, my membership is liable to be cancelled /
terminated.
I further declare that I have not at any time been a member of the Institute/applied earlier for membership of the Institute.
c)
d)
Date:
I hereby agree, if admitted, to be bound by the Memorandum and Articles of Association of the Institute. I am aware that, if
admitted as an Ordinary Member, as per the provisions of the Articles of Association of the Institute, I shall be liable, in the
event of the Institute being wound up, to contribute towards its liabilities a sum not exceeding Re.1/-.
I confirm having read and understood the rules and regulations of the Institute and I hereby agree to abide by the same. In case I
am desirous of instituting any legal proceedings against the Institute I hereby agree that such legal proceedings shall be instituted
only in courts at Mumbai, within the state of Maharashtra and not in any other court.
Place:
Signature of the Applicant:
PARTICULARS FOR MEMBER’S IDENTITY CARD
Membership No.
For Office use only
1) Full Name Mr./Ms./Mrs. :
(As Recorded with Employer)
2)
Bank / Institution working with: ……………………………………………. Branch………………………………….
SPECIMEN SIGNATURES
(to be signed in two boxes)
:
Applicant’s one
colour Photograph
of
1 ½” x 1 ½” size
duly signed across
by applicant
(to be stapled here)
INSTRUCTIONS TO APPLICANTS
1)
The application is to be filled in CAPITAL letters only.
2)
Membership of the Institute is open only to the staff of recognized banking / financial Institutions /
Corporations in India and abroad
3)
Membership application form must be completed in all respects and forwarded to the Institute alongwith One
Time Membership Fee of Rs.1,500/- for applicants from India and US $ 150 for applicants from other
countries.
4)
Submission of membership application form with Demand Draft for the requisite amount be
drawn in favour of "Indian Institute of Banking & Finance" payable at city where the respective
zonal office is located - SZO-Chennai, NZO-Delhi, EZO-Kolkata, WZO-Mumbai
5)
Membership number will be sent within a month, if the Membership Application form is found to be in order.
6)
7)
A permanent I-card will be issued to the Members which should be produced at the time of examination and
whenever demanded for availing other services.
The addresses of the four Zonal Offices alongwith the Corresponding States falling under each Zone and also
of the Corporate Office are given below:
Western Zonal Office
(Gujarat, Madhya Pradesh, Chattisgarh, Maharashtra, Rajasthan, Goa, Dadra and Nagar Haveli, Daman &
Diu).
DEPUTY DIRECTOR - Indian Institute of Banking & Finance, 193, Maker Towers 'F', 19th floor, Cuffe
Parade, MUMBAI 400 005
Tel.No.: 022-22185134/2183302, Fax: 022-22180845 Email: iibwz@iibf.org.in
Southern Zonal Office
(Andhra Pradesh, Karnataka, Kerala, Tamilnadu, Lakshwadeep, Pondicherry)
DEPUTY DIRECTOR - Indian Institute of Banking & Finance, No.94, Jawaharlal Nehru Road (100 Feet
Road), Opp. To Hotel Ambica Empire , Vadapalani, CHENNAI - 600 026, Tel.No.s.044-24722990,
24728325, 23721429(D), Fax:044-24726966, Email: iibsz@iibf.org.in
Eastern Zonal Office
(Assam, Bihar, Manipur, Meghalaya, Mizoram, Nagaland, Orissa, Sikkim, West Bengal, Andaman &
Nicobar Islands, Arunachal Pradesh, Tripura, Jharkhand)
DEPUTY DIRECTOR - Indian Institute of Banking & Finance, 408, “Anandlok”, 4th Floor , 227, Acharya
J.C.Bose Road , Kolkata
- 700 020, TelNos.033-22809681/82/83, Fax:033-22809680, Email:
iibez@iibf.org.in
Northern Zonal Office
(Haryana, Himachal Pradesh, Jammu & Kashmir, Punjab, U.P., Uttaranchal Delhi, Chandigarh).
DEPUTY DIRECTOR- Indian Institute of Banking & Finance, Vikrant Tower , 1st Floor, 4, Rajendra
Place, New Delhi – 110008, Telephone: 011-25752191/92, Fax: 011-25752193,
E-Mail: ibnz@iibf.org.in
Corporate Office (for Overseas Members)
DEPUTY DIRECTOR, Corporate Development & Membership, Indian Institute of Banking &
Finance,World Trade Centre,”The Arcade”, 2nd floor, Cuffe Parade, Mumbai 400 005.
Tel.No.022-22187003/4/5 Fax:022-22185147 Email: mem-services@iibf.org.in
HELP US TO SERVE YOU BETTER:
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Please write all the details legibly in this application form.
Please send your application form and all your communications to the appropriate Office only under which
your state falls. Overseas members may send their form to the Corporate Office.
It is necessary to inform any change in your address immediately, to the concerned Office to enable us to
provide you all the services
Visit our website http://www.iibf.org.in
-oOo-