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

Signature of the Applicant *

Place

Seal in case of Company/ Society/Entity

Visit the Website www.maadhyaminternational.com to download the Application form and for details of Membership Categories.
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.