Membership form

Please fill in the following fields and click \"Formular Absenden\" to submit. All fields marked with asterisk require compulsory entries. If any of the mandatory fields are not applicable to you, please fill in NA and submit the form.

Applicant\'s Full Name *

Title *

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Occupation *

Affiliation (Department/Institute/Industry) *

Nationality *

Address for Communication

Street, House number *

Postal Code, City *

Email *

Living in Goettingen since

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Any other relevant information

I, hereby, agree to register myself as a member of Nirmiti, association of Indians in Goettingen.

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