prism-bullet1 Membership Form

Name of the Organisation*
Registered Office
Head Office

Principal Representative


Alternate Representative


Products / Services

Product 1
Product 2
Product 3
Product 4
ISO 9001 Certification , state the date of Validity
Other certification
Turnover last two years in million Rs
Investment in plant and Machinery
No. of employees & Management Staff.
Admission Fee of INR 10000/- PLUS First Annual Fee payable with the Application. {Via NEFT/DD/Cheque No. Payable at PUNE at par to “MECHATRONICA CLUSTER”} . (Note 2 below)

Bank Details
Organisational Adherence to Membership Requirements
I affirm that my organisation shall conform to the Objectives of the Mechatronica Cluster and will strive to abide by the Code of Conduct as stated on its website ( on being admitted as a member. I also attest that all the information provided above is correct. :
I agree with the terms and conditions.

PAYMENT via NEFT: Beneficiary: Mechatronica Cluster,

Current Account Number :31737582220.
State Bank of India; Branch -11698 –Mayfair Eleganza, NIBM Road, PUNE 411048.
IFS Code : : SBIN0011698. .
{Advice details of NEFT payment to;and}.

NOTE 2: Annual fee based on T.O. of last financial year.
Annual Fee = INR 5000/- for companies with T.O. up to 7.5 Cr.;
INR 7500/- for T.O above 7.5 Cr and up to 20 Cr. and
INR 10,000/- for T.O above 20Cr.

NOTE 3: For further information, Contact : Mr Dhritimon Merchant,Hon.Secy:+91 98 211 62664 OR [} OR}.

Admission Fee of INR 10000/- PLUS First Annual Fee payable with