Individual /Institutional Membership Form

  • Home
  • /
  • Individual /Institutional Membership Form

    First Name *

    Last Name *

    Permanent Address *

    Temporary Address

    Contact No *

    Other Contact No

    E-mail Id *

    Other E-mail Id

    Contact Person

    Designation

    Department

    Company Name *

    Sales : (Export) *

    Domestic : *

    Purchase : (Import) *

    Classification :
    SMALLMEDIUMLARGEMNC100% EOUOTHER

    Type Of Industries :
    ChemiclsPharmaceuticalsEngineeringPlasticsFood ProcessingPetrochemicalsElecricalElectronicsRubber ProductsGlass PackingITOther

    Activity :
    ConsultancyProfessionalService ProviderManufacturingExpoterImpoterOther

    Referred By :

    Application Approved in EC Meeting Held on :

    Foreign Collaboration : (If Any)

    − 7 = 1

     

     

    * Membership Fees :

    • Institutional Member : Rs. 4000/- Per year
    • Each SubSequent Member : RS. 2500/- Per Year
    • Individual Member : RS. 2500/- Per Year

    * Entrance Fees : (One time Only)

    • Institutional Member : Rs. 4000/- Per year
    • Individual Member : RS. 2500/- Per Year

    Note :

    1. Institutions taking up more than one membership, must fill application from for each membership.
    2. All communication will be addressed to the person named in the membership application form. Please there for provide correct designation, department, email ID, Contact no., etc.
    3. For applications received after 1st october 50% concession in annual memebership fees allowed. Entrance fees will remain the same.
    4. Cheque / D.D. in favour of EXIMCLUB, payable at VADODARA to accompany application form.