Space Club: Registration

Member Login
User ID
Password

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Space Astronomy Club Registration

Club Interest *

Name *

Gender*

Date of Birth*

Marital Status*

Address*

Country*

State*

District*

Pincode*

Mobile No

Home / Alternetive Phone *

Occupation*

Existing Email id (Username) *

Password *

Confirm Password *

Paying Through*

Upload Photograph

Upload Photograph File size allow upto 1 MB(1024 KB)

if you don't have a scanned photo please send us your passport size photograph for id card.

Dependent Information

	Name	Age	Relation
1.
2.

Pls send the dependent's Photo.

Please provide details of any 2 family members who may attend the events when member is not available.

Please send the Cheque/DD on the name of "Space Technology & Education Private Limited" at the following address "Space Astronomy Club, Space Technology & Education Private Limited, WZ-19 First Floor, Asalatpur, A-3 Janak Puri, Pin: 110058". For any help regarding filling up the regisration form, call us at <9250901042> from Monday to Friday between 9.30 am to 6.00pm or email us at <sac@stepl.org>.