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ALL INDIA ELECTRONICS ASSOCIATION

South Zone: Jhaveri Hall, 4/F, 'M' Block, Khaleel Shiraz Estate, Pantheon Road, Chennal - 600 008.

Telephone: 2819 4353 Website: www.airea.org

APPLICATION FOR MEMBERSHIP

PLEASE FILL ALL DETAILS IN THE FORM USING CAPITAL LETTERS ONLY

Type of Membership      Life Member       Ordinary       Others specify      

Name of the Organization
Mailing Address
Established in the year
Phone Nos
Cell
Res
Email
Branch Address
Branch Phone
Email
TIN/ GST Registration No
Area Code
Date
Pan No
Date
Nature of Business

Trading            Manufacturing            Repairs & Servicing            Other           

Products Handled
1
2
3
Signature
Name(s) of the Proprietor/ Partner/ Director
1
2
3
4
Authorized representatives who will attend meetings. Name of 2 Persons
Mr/Mrs/Ms.
Educational Qualification
Mr/Mrs/Ms.
Educational Qualification
Signature
Signature






Organization's Address Seal
TERMS & CONDITIONS of MEMBERSHIP
I/We desire to be enrolled as Life/ Ordinary member of the Association through the South Zone, and hereby agree to be bound by the Memorandum and articles of the Association, the Zonal rules & regulations, the by laws and the decisions of the of the Central Zone committee on enrolment tas a member The Information furnished in this application form is true and correct to the best of my knowledge The entrance and membership fee is enclosed
Proposed by Mr.





Signature of the member with company seal
Seconded by Mr.





Signature of the member with company seal
Payment enclosed


Cheque/DD
No
Date
On _____________________ Bank

FOR OFFICE USE

Type of membership
LIFE
ORDINARY
Received on
Receipt No & Date
Register No.
Approved in the Zonal Committee meeting



held on ________________________
President
Secretary
Registered office: 301, Sukh Sagar, N.S.Patkar Marg, MUMBAI - 400 007