ISA Delhi Section Membership Enrollment Form
Mail duly filled in form to ISA Delhi Section, Rewards for Recruiting Program:
33, DSIDC, CWC Kalkaji, New Delhi -110019 with ISA Sponsor Name …………………………………………….
Payment of Rs. 4000/- (UPI: isadelhi@ybl)
Tel.no. 9313384543 (PAYTM, PHONEPE or GOOGLEPAY) ISA Sponsor Membership ……………………………………..
Cheque/DD : “The Instrumentation Systems and Automation Society Delhi Section” A/c no. 06291131003341 (PNB ), IFSC: PUNB0062910
1. Member Information This Section must be completed in full.
Mr. Ms. Dr.
Name Last/Family (Include suffix and /or professional designation) First/Given Middle
Company Position/Title
Business Address Information : This section must be completed to receive the FREE subscription to Motion Control magazine. (See section 4b.)
Street address/PO Box Mail Stop
City State/Province Postal Code
Country E-mail
Telephone include area code of country and city code Fax (include area code or country and city code)
Home Address Information :
Street address/PO Box Unit
City State/Province Postal Code
Country E-mail
Telephone (include area code of country and city code) Celular/Alernate Phone (include area code or country and city code)
Preferred Mailing Address (check one): Business Home Preferred Billing Address (check one) : Business Home
Birth date (month/day/year) Would you like information on senior Membership? Yes No
Have you ever been a member of ISA? Yes No If yes, list last year of membership : ________________________________________
Highest degree earned : High School Associate/Vocational Bachelors Masters Doctorate
STUDENTS ONLY : _________________________________________________________________________________________________________________
School Required : Date of graduation (mm/yyyy)
2. Job Information This section must be completed in full.
2A. Check your primary job function (choose only one) 2B. Check your Industry classification : (choose only one)
Manufacturing Industries Transportation and Public Utilities
Control Systems Engineering (B) Chemicals (2800) Transportation – Aerospace (3760)
Education (N) Electronic & Other Electric Equipment (3600) Transportation – Aircraft (3720)
Engineering Consulting (AG) Food (2000) Transportation – Automotive (3710)
Engineering Management (3) Industrial Machinery & Equipment, Including Computers (3500) Transportation (3700)
Environmental Control’s (AI) Instrumentation, Measurement, Analysis & Control Apparatus (3800) Utilities (4900)
General or Corporate Management (A) Medical Instrumentation & Systems (3840) Utilities – Electrical (4910)
Marketing or Sales (C) Petroleum Refining & Related Industries (2900) Utilities – Natural Gas (4920)
Measurement, Testing, Quality or Standards Engineering (I) Pharmaceuticals (2830) Utilities – Combination (Nuclear/Fossil Fuel, etc.) (4930)
OEM Product/Systems Engineering (A2) Primary Metals (3300) Utilities – Pipelines except Natural Gas (4600)
Plant Information Systems (G) Pulp, Paper & Allied Products (2600) Utilities – Water/Wastewater (4940)
Product Design Engineering, Including applied R & D (1) Rubber & Miscellaneous Plastics (3000) Engineering & Other Services
Production Engineering (D) Semiconductors & Electronic Components (3670) Communications/Data Distribution (4810)
Research & Development (J) Stone, Clay, Glass and Concrete Products (3200) Construction (1700)
Safety, Systems Engineering (AJ) Textiles (2200) Education (8200)
Software Engineering (F) Tobacco Products (2100) Engineering Services (8710)
Systems Design Engineering (S) Valves, Fittings, Fabricated Metal Products (3400) Government (9100)
Systems Integration (H) Mining Instrument & Control Apparatus Sales & Service (5000)
Technical or Engineering Support (K) Metal Mining (1000) Management Consulting (8740)
Other (P) ___________________________________________ Oil and Gas Extraction (1300) Research, Development & Testing (8730)
SIGNATURE : This application cannot be processed without your signature
Signature Date :
