Name of Organization*

Name of Proprietor/Partners/Directors *

Full Address of Organisation *

Nature of Organisation (Type of Business)*

Name of Representative *

Mobile Number of Representative (with Whatsapp) *

Email for official communication *

GST Number *

Name of Representative *

I hereby declare that I have understood the rules and regulations of the association and will abide by the same. All information given in this application are true to the best of my knowledge and belief.