Scribd
Upload
68 views

Membership Application Form: #51, 15th Cross, AECS Layout, Sanjaynagar. Bangalore - 560094

The document is a membership application form for the Engineering Manufacturer Entrepreneurs Resource Group (eMERG). It requests personal and business details from applicants. Section A asks for contact information while Section B requests business details for individual proprietors and registered companies. Section C is for specifying the requested membership. The form notes that applicants must agree to abide by eMERG rules and pay membership fees within 5 days of approval. It provides the membership fee structure including annual fees of INR 1200 and options for admission fees and life membership.

Uploaded by

swarna
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
68 views

Membership Application Form: #51, 15th Cross, AECS Layout, Sanjaynagar. Bangalore - 560094

The document is a membership application form for the Engineering Manufacturer Entrepreneurs Resource Group (eMERG). It requests personal and business details from applicants. Section A asks for contact information while Section B requests business details for individual proprietors and registered companies. Section C is for specifying the requested membership. The form notes that applicants must agree to abide by eMERG rules and pay membership fees within 5 days of approval. It provides the membership fee structure including annual fees of INR 1200 and options for admission fees and life membership.

Uploaded by

swarna
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 2

MEMBERSHIP APPLICATION FORM

For Women in Technology, Business, Profession &Service

To
The Hon. Secretary,
ENGINEERING MANUFACTURER ENTREPRENEURS RESOURCE GROUP
#51, 15th cross, AECS layout, Sanjaynagar. Bangalore - 560094
Telefax: 080 42061929email ID: [email protected]
website : www.emergindia.org
Photo

Section A: Personal Details


a. Name (In Block Letters): ………………………………………………………………………………
b.Address Communication Should Be Sent To :…………………………………………………………
………………………………………………………………………………………………………………..
c. Tel: ………………………… d: Email: …………………………………
e. Personal PAN No: ………………………………….
f. List of Orgs that you are member of: ………………………………………………………………….
g. Awards / Recognitions if any: ………………………………………………………………………….
……………………………………………………………………………………………………………….
h. Category applying under (please check the relevant box):

Individual Proprietorship Public Ltd. Co Private Limited Co


Partnership Corporate Association Women’s Group
Institution Working professional Others (Pl specify)

Section B1: Business Details(Individuals and Registered Companies)


a. Business Name:…………………………………………………………………………………………..
b. Business Address: ……………………………………………………………………………
…………………………………………………………………………………………………………………
c. Bus Tel: ………………………. d. Bus Email: ………………………………..
e.Nature of the Business, Products and Services Provided: ……………………………………………
………………………………………………………………………………………………………………….
………………………………………………………………………………………………………………….
…………………………………………………………………………………………………………………..
…………………………………………………………………………………………………………………..
f. Your Designation and Responsibilities: …………………………………………………………………
….………………………………………………………………………………………………………………
………………………………………………………………………………………………………………….
………………………………………………………………………………………………………………….
g. Year Business Established: ………….. h. Bus Website: ………………………………………

i. Referred by ………………………………………..
j. How did you come to know about eMERG? ……………………………………......
Section B2: Business Details (Registered Companies Only)

a. Business PAN No / GST No: ……………………………………………………………………………


b. Co / Udyog Aadhar (UAM) Registration No. and Date: ……………………………………………………
c. Total Number of Employees:……
d. How many employees are:
Women: …… Women in a technical role: ……

e: Investment in Indian Rupees (INR): ……………….


f:Turnover in INR: Last 3 Financial Years (2016-17) (2017-2018) ( 2018-19)
…………… …………….. …………….

Section C: Membership Details


a.Membership requested in the name (s) of:

1. Name: Designation: Phone (O) (R)

2. Name: Designation: Phone (O) (R)

I / we desire to enroll as member (s) of eMERG. I / We agreed to abide by the rules and regulations of
eMERGprevailing now and as and when amended.I / We will pay the mandated membership fee
within5 days of approval of this application by the eMERGExecutive Committee.

Company Seal (if available) Name: …………………………….. Signature: …………………………………

Date:………………………………………..

For Office Use Only:


Membership For TheYear ……………
Accepted [ ] Membership No: ……………… Rejected [ ] Date: ……………..
Remarks Signature ………………….
Payment Details: ……………………………………………………………………………………………..

MEMBERSHIP FEE STRUCTURE


Membership Fee is INR 1200 ADMISSION FEE LIFE MEMBERSHIP ELIGIBILITY FOR MEMBERSHIP
considered from 1st April to March One time admission Fee of Life Membership Fee is Any woman in technology, business,
31st and paid on pro rata basis on INR 1000/- is payable INR 12,000/ and is a one time profession& servicecan become a
the year of joining. The specified along with Annual payment. member of eMERG.
membership fee should be paid Membership Fee.
within 5 days of Application Eligible after 2 years as
Approval. AdmissionFee is non eMERG member
Annual Membership Fee is non
refundable.
refundable and due on April 15th
ever year.

eMERG - A team with a passion to grow

You might also like