Registration Form for Corporate Membership
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   Subscription Structure for Corporate Membership
   Entrance    Rs. 5000/- p.a.
   Annual    Rs. 5000/- p.a.
   Rs. 20,000/- for 5 years, if paid

   Fields marked with * are mandatory.

* Name of the Company

:

* Type of Organisation :

* Company Address :

* City  :
* Date  :
* Zipcode :
* State   :
* Country   :
* Telephone Number (Off.) :

 Fax (Off.) :

 E-mail :

* Representative's Name :

* Designation :

 Residence Address :

 Telephone Number (Res) :

 Fax (Res) :

     
    Names of two other Executives of your company to whom
    communication can be sent.
   
       Name        Name
         
      Designation        Designation
         
     

Nature of Business

:

Turnover

:

  Objective of joining Indo-American Society

:

Company's affiliation to the United States of America (If any)

: