1

Name in Full: Prof. / Dr. / Mr./Mrs.

:

Prof. Anjali Devi.C.

2

Present Position/ Designation

:

Professor in Food & Nutrition, Osmania University College for Women’s, Koti.

3

Address

:

4

Phone No

:

24657813

5

Fax No

:

6

E-Mail

:

anjalicyanam@yahoo.com

7

Name of the College from where he / she has studied last

:

8

Courses studied

:

9

Year(s) of Study : From - To

:

10

Payment for membership is being made as  under

:

11

Cheque / DD No

:

13

Date

:

14

Bank

:

15

Amount (Rs)

:

 Rs. 500/-