1

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

 :

Mr. John Samson. D

2

Present Position/ Designation

:

3

Address

:

Flat no. 405, Shubhnivas Apts., Nagarjuna nagar colony, St. no. 1, Lane 14, Tarnaka, Sec-bad-500  017.

4

Phone No

:

5

Fax No

:

6

E-Mail

:

7

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

:

Law College, O.U.

8

Courses studied

:

LLB & LLM.

9

Year(s) of Study : From - To

:

1984-1990

10

Payment for membership is being made as  under

:

11

Cheque / DD No

:

917566

13

Date

:

18/03/06

14

Bank

:

SBH

15

Amount (Rs)

:

Rs.500/-