:: Membership Form - Life

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Personal Information
Salutation *
First Name *
Middle Name
Last Name *
EMail *
DOB *
Spouse's Name
Spouse's DOB
Anniversary Date
Blood Group
Proposed By
Seconded By
Office Name *
 
 

Contact Information (One Of Contact Information is Compulsory)
 
Residential Address
 
Office Address
Address1 *
Address1 *
Address2 *
Address2 *
Pincode *
Pincode *
City *
City *
State *
State *
Country *
Country *
Phone No. *
--
Phone No. *
-- Extn
Fax
--
Phone No.
-- Extn
Mobile
-
Fax
--
 
 
Email
 
Communication Address :

 

Other Information
Qualifications *
Designation
Other Membership No.
Hobbies

Profession *
Status *
Chamber Activity


Area Of Intrest



Membership Fees
Membership Fees Amount Select
Entrance Fees 9500
I.T. Review Subscription 550
Study Group Meetings (Direct Taxes) 1250
Study Circle Meetings (Direct Taxes) 600
Indirect Taxes & Other Laws Study Circle Meetings 600
Study Circle Meetings (International Tax) 1000
Series of Lecture Meetings on Self Awareness 350

Total Rs.   
Payment Mode
 
 
Bank Name *
Branch*
Cheque/Draft No. *
Date*