ACTA Membership Application | Assam College Teachers' Association

Application form

Membership Registration

Teacher's membership form

Full Name *

Only letters, spaces & dots (.) allowed

College / Institution *

Subject Teaching *

Date of Birth *

Date of Joining (service) *

Date of Retirement *

Retirement date from service (required)

Residential / Postal Address *

Zone *

Mobile Number *

Only digits, exactly 10 numbers

Email Address *

No Objection from Teacher's Association *

Allowed: PDF, DOC, DOCX, JPG, JPEG, PNG, GIF (Max 5MB)

All information is protected and will be used only for ACTA records.