Membership Form
 
 
Membership Form
 
Name :
  
Sex :
   Male Female
Address (Office) :
  
Address (Home) :
  
Phone (Office) :
  
Phone (Home) :
  
Email Address :
  
Year of joining HITRT :
  
Year of leaving HITRT :
  
Position in .
Haffkine Institute :
   Student Visiting Fellow
Scientific Staff Academic Staff
Employee
Department while at .
Haffkine Institute :
  
Degree obtained .
through Haffkine .
Institute :
   M. Sc. M. Tech. M. Phil.
Ph. D. M. D. D. M. L. T.
Year
   
Haffkine Institute for Training, Research and Testing