INTERNATIONAL BANK NOTES SOCIETY •

INDIA BANKNOTE COLLECTOR\'S CHAPER

C/O Marudararts ,#85 M.G. Road, Bangalore 560 001, India.

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Membership Application Form

Name in Full :

Address :

Pincode:

City:

State:

Country:

Mobile:

Email:

Facsimile No:

Website:

Collecting Interests:

Are you a banknote dealer?

Yes No

If you are a member of an IBNS Chapter, indicate the chapter :

Do you want the following in IBNS-IBCC Directory?

Postal Address & Website:

Yes No

Email:

Yes No

Do you want the following displayed in the PDF Version of IBNS-IBCC Directory?

Postal Address & Website:

Yes No

Email:

Yes No

Do you want your name and email address posted on IBNS-IBCC website?(For access by members only)

Yes No

How did you find out about the IBNS India Banknote Colletor's Chapter?(add a tick)

IBNS Website / Advertising in a magazine / Advertising in ' World Paper Money ' catalogue /

An article in a magazine / Another IBNS-IBCC Member / Other

Select the most appropriate region in which you live : (add a tick)

Western Hemisphere/ Europe, Africa and Middle East/ Australia, East Asia and Indian Sub-continent/ Other

	Name	Membership No.	Known to candidate for
PROPOSER			Years
SECONDER			Years

Membership type description	Fee Amount in INR
REGULAR / INDIVIUAL. Any person 18 years of age or older who is interested in paper currency and is in sympathy with the aims and objectives of IBNS India banknote Collectors Chapter may apply for regular membership.	Rs. 250/- p.a.
JUNIOR.Availble to yount people, under the age of 18, who are interested in paper money.The application for membership has to endorsed by a parent or legal guardian.	Rs. 150/- p.a. (Under 18 years)
LIFE: Lifetime Membership	Rs. 2500/-
FAMILY: Family membership issued in the name of an individual applicant who would otherwise be eligible for regular membership It includes the applicant and immediate family (spouse and minor children) listed on the application.	Rs. 500/- p.a.
GROUP: Non-IBNS / IBNS IBCC-affiliated numismatic firms, clubs or societies, libraries, museums, archives, schools, or similar organizations are eligible for group membership.They pay the same subscription rate as regular individual members.	Rs. 1000/- p.a.
INSTITUTIONAL: Financial Institutions.	Rs. 5000/- p.a.

Banking details for the required payment :

Account Name : I B N Society

Account Number : 3146-3276-176

Bank Name : State Bank of India

IFSC Code : SBIN0003298

Branch : Shivajinagar

Please note that by completing this form you will be applying for membership of the IBNS India Banknote Collector Chapter.

On receipt of your application and payment, you will be sent a confirmation on being accepted as a member.

Applicant Signature

Name in Full :

Address :

Pincode:

City:

State:

Country:

Mobile:

Email:

Facsimile No:

Website:

Collecting Interests:

Are you a banknote dealer?

If you are a member of an IBNS Chapter, indicate the chapter :

Postal Address & Website:

Email:

Postal Address & Website:

Email:

Date of Brith (Junior Applicants Only) :