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prism-bullet1 Membership Form

Name of the Organisation*

Your Email address (required)

Website address*

Name of Head of the Organisation(Chairman/CMD/MD/CEO/Owner)

Registered Office

Head Office

Principal Representative (Who will represent the company/firm for Mechatronica Cluster); His Tel. No., Email Id and Mobile No.

Name

Number

Mobile

Alternate Representative (Who will represent the company/firm for Mechatronica Cluster); His Tel. No., Email Id and Mobile No.

Name

Number

Mobile

Products / Services

Product 1

Product 2

Product 3

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)

Advice Details of NEFT

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 (www.incomech.org) on being admitted as a member. I also attest that all the information provided above is correct. :

I agree with the terms and conditions



NOTE 1:
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 kesarsingh@metafold.com;and sales@cmdindia.com}.


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 [sales@cmdindia.com} OR president@incomech.org}.