|
 |
 |
MEMBERSHIP : |
|
| Form |
Name: Mr./ Mrs./Ms./ ______________________________________
Date of Birth: _________________________ (Optional)
Work Details:
Company Name: _________________________________________
Designation:_____________________________________________
Address: _______________________________________________
_______________________________________________
_______________________________________________
Tel: ___________________________
Fax:___________________________
E-Mail: _________________________
Residential Information:
Address: _______________________________________________
_______________________________________________
Tel: _________________________________
Mobile: ______________________________
Fax: ______________________________
E-Mail: _____________________________
Preferred Contact Point: Office / Residence
Family Details
Name of Spouse:______________________________________
No. Of Children: _____________
Name of Children: _____________________________________
_____________________________________
_____________________________________
Family in China: Yes / No
Interest Areas: ________________________________________
________________________________________
Emergency Contact: _______________________________
_______________________________
_______________________________
Type of Membership Applied for : Individual / Family
Signature : ___________________ Date: ____/ ____/ _______
Please note current Membership Valid until Dec 2007
For Indian Association Use Only
Received RMB ________________ on _____/______/_________
Membership Number : ________________________________
|
|
| |
