img
img
Name*
Father's Name*
C.N.I.C. No.*
Date of Birth*
Nationality*
Permanenet* Address
Phone*
Fax*
Mobile*

Email*

URL*
Education*
Occupation*
Company*
Desigation*
Special* Interests/Hobbies
Annual Membership Fee
General / Individual Rs. 2,000/-
Associate Membership Rs. 5,000/-
Corporate Membership Rs. 8,000/-
The Payment should be made through cheque/draft in favour of National Forum for Environment & Health (NFEH).
I here under declare that the information furnished by me is true and correct to the best of my knowledge and belief.
I undertake to abide by the rules and regulation of National Forum for Environment & Health.
   
Message*