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MEMBERSHIP FORM
 
 
 
 
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NAME OF THE APPLICANT
:  
 
*
NAME OF THE REPRESENTATIVE :  
 
*
OFFICE ADDRESS :  
 
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RESIDENTIAL ADDRESS :  
 
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TELEPHONE :  

(O)
(R)

 
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MOBILE :  
 
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FAX :  
 
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E-MAIL :  
 
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WEBSITE :  
 
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PAN NO :  
 
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SERVICE TAX REGN NO :  
 
       
 
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TYPE OF MEMBERSHIP :   CORPORATE
 
     
 
       
 
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ORGANISATIONAL DETAILS
(TICK WHICHEVER IS APPLICABLE)
:   Public Limited Company
Private Ltd Company
Partnership Firm
Individual/Proprietor Firm
 
 
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NAMES OF DIRECTORS
/PARTNERS/PROPRIETOR/REPRESENTATIVE
:  
 
 
       
 
*
Upload Photo :  
         
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APRA Membership Fees
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Corporate Membership : Rs. 25,000/-
Individual/Proprietorship/Partnership/Pvt Ltd. :  Rs. 15,000/-
 
 
APRA Annual Renewal Fees
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Corporate Membership : Rs. 6,000/- p.a
Individual/Proprietorship/Partnership/Pvt Ltd. : Rs. 3,000/- p.a
 

 
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