*Name of the company
Full address of the Company
*office
*Factory
Branch if any
*Telephone No
Fax
*E-mail
Website
*C.E.O / Director / M.D
Name
*Designation
Name of Company Representative to ELIAP
Designation
*Company VAT Registration Number
(Enclose Xerox copy of Certificate)
*SSI Registration
Yes No
Date of Registration
Capital Invested (Cumulative) Rs
*No. of Employees
Annual Turnover  Rs.
Products manufactured
(kindly enclose leaflets, Brochures of
your products)
Introduced by
(Name of ELIAP member)
Type of Membership
(please tick appropriate category)
 
CORPORATE PATRON FULL  ASSOCIATION
Cheque for Rs. towards admission fee and Rs.
Towards annual subscription enclosed.
Date
Fields marked with * are mandatory