Maadhyam | Membership From

MEMBERSHIP FORM

Full Name of the Applicant *

Father's Name/ Husband Name *

Date of Birth *

Status *

Address *

Pincode *

Mobile Number

Fax

Website Link

Email *

Name and address of the Incorporated Company/Registered/Society/ Entity:

Name

Address

Country

State

Pincode

Contact

Fax

Website Link

Incorporation Certificate

Secretariat : C-524, Defence Colony, New Delhi,India-110024 Tel.No.11 91 49429433 Email id:info@maadhyaminternational.com Website: www.maadhyaminternational.com

Year of Incorporation / Registration

Qualifications/Area of Activity

Address for Correspondence, if any

Pincode

Contact

Fax

Is there any pending enquiry / legal proceedings against the Applicant? *

Membership Categories *

Fee(Included GST 18%)

Brief note about the applicant (100 words)

In what way the Applicant will contribute to Maadhyam?

DECLARATION

I have read and understood and I hereby agree to be bound by the Memorandum of Association of Maadhyam and the Membership Rules/ Regulations framed there under, as may be amended or framed from time to time.

Date

Place

Seal in case of Company/ Society/Entity

If your application is accepted, you shall be suitably intimated.
Acceptance of the application for membership shall be at the sole and absolute discretion of the Membership Committee.