Membership Application Membership Application Leave this field blank Mr. / Mrs. / Dr. / Prof. Mr. Mrs. Dr. Prof. First Name Middle Name Last Name Designation Subject Area of Specialization Department Institute/ College/ University Mobile No. Email Address Type of Membership Petron Member Life Member General Member Fellowship Donate here Registration Fee 10,000 (Petron Member) 5,000 (Life Member) 600 (General Member) 2000 Fellowship Donate here Submit Form Bank Details Name of Beneficiary : Environment and Social Welfare Society Account Number : 77352200000561 IFS code : CNRB0017735 MICR Code : 471015002 SWIFT code : CNRBINBBBFD Name of Bank : Canara Bank, Branch 2 Chhatarpur, Madhya Pradesh ,India