APPLICATION: ASSOCIATE MEMBER

A. PERSONAL DETAILS:

Name: _________________ DOB (& Age): _________________ Section: _____

Mobile: ________________ Landline: ______________________
E-mails: _______________________________________________
Address:
Permanent Address Current Address

B. EDUCATION & EXTRA CURRICULAR ACTIVITIES:

Level Stream Institute & Board & Univ. % ECA

10th Std.
12th Std.
Grad 1st
Yr
Grad 2nd
Yr.
Grad 3rd
Yr.
Grad 4th
Yr.
Grad
Overall
Others

Any Additional Extra Curricular Activities that you would like to mention:
____________________________________________________________________
____________________________________________________________________
__

Are you a member of/applied for membership of any other team/group/association at

IGSM? (If yes, please specify):
____________________________________________________________________
 ____________________________________________________________________
__

Any special Award that has been presented to you by your School/College:
_______________________________________________________________________
___________________________________________________________________

C. FAMILY DETAILS
S Name DOB Relation Occupation
.
N
o
.

D. WORK EXPERIENCE (if any)

S Organization Period Designation & Role
.
N
o
.

E. SKILL UTILIZATION

(Rank 1 I what you know you would b best in & Rank 4 is what dos not suit your
skill-set)
I would consider my skills best used in:
S Area My Ranking
.
N
o
.
1 Creating and maintaining databases ( working on Excel Sheet)
2 Designing and modifying web-pages, handling website related issues
(Photoshop)
3 Organizing events like parties, seminars, workshops, get-togethers
4 Preparing & Editing News-letters, posters & various other tools of
communication
With respect to your top-two choices, what is the knowledge/skills that you possess
that will enable you to perform those tasks (please specify separately for each area)?
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
_______

What Value addition would you provide to the IAA Committee?

____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
_______

F. HOBBIES
My Hobbies include…
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
_____

G. DECLARATION

I would like to apply for the position of Associate member in the IAA Committee I am aware
that the position demands working extra hours as well as sacrificing Holidays/Saturdays
& Sundays for IAA Activities assigned to me. These activities would be over & above the
regular classes, course – work, projects & activities assigned to me as part of the PG course
that I have enrolled for at IGSM. My participation in other groups/teams/associations would
not be the cause of not fulfilling my roles & responsibilities assigned to me by the IAA
committee. I am also aware that being selected as an Associate Members in the 1 st Year does
not guarantee automatic transition into the role in the 2nd year. My position in the IAA
Committee is subject to my performance in the team. The Executive Committee of the IAA
has the right to review the performance of an Associate Member and retain/remove a member
at any stage.

Signature __________________
Date: _________________ Name (_________________)