Request for Subscription/Change of address

Name
Gender Female   Male
Highest Qualification
Describe your job Doctor  Engineer  Journalist  Researcher  Teacher  Science Communicator  Student  Any other 
Please Specify *  
Address
State Pin Code
Phone No.
Email
No. off persons who may read your copy of Dream 2047
At present DREAM2047 is bilingual ( Hindi and English).In case we decide to publish seprate Hindi and English versions, witch one would you prefer to subscribe? abc   abc   abc   abc
For existing subscribers: rating of regular columns on a scale of 1 (poor) to 10 (excellent)
Popular article on science and Technology Health
Your opinion Editorial
Biographies of scientists Interview of Personalities
Recent Development in Science & Technology Any Other
I would like to recive electronic version ( strike out one option) abc   abc   abc   abc
Subscription No.
Approximate No. of years since you have been receiving DREAM 2047
Any suggestions to improve Dream2047.
11 + 8 =