IAPQR, Indian Association for Productivity Quality & Reliability

Printer Friendly Institutional Membership Form

INDIAN ASSOCIATION FOR PRODUCTIVITY, QUALITY & RELIABILITY
	( Affiliated to the International Statistical Institute ) Address: AD-276, Sector - I, Salt Lake City, Kolkata 700 064. Phone No.: 91-33-2334 6234/3 (12 Noon - 7 p.m.); Telefax: 91-33-2334 6234 Email: iapqr@yahoo.co.in

Application for Admission to Institutional Membership

We have gone through rules and regulations of your society and being interested/ involved in the quality Movement in India, desire to be enrolled as an institutional member of society. Details regarding our two duly authorised representatives are given below. An amount of Rs.5,000 p.a as subscription is being sent in cash/Bank Draft drawn in favour of Indian Association for Productivity, Quality & Reliability.

Date: ____________
	Signature of the Authorised Person

Name of the Organisation:

Address:

Telephone: __________

e-mail: _________________

Fax: __________

Principal Nominee

1. Name:

2. Address:

a)Office
b)Residence

3. Designation:

4. Qualification (with Specialisation):

5. Telephone No.

a) Office: _____________

b) Residence:____________

Alternate Nominee

1. Name:

2. Address:

a)Office
b)Residence

3. Designation:

4. Qualification (with Specialisation):

5. Telephone No.

a) Office: _____________

b) Residence:____________

For Office Use only

Application

i) received on _____________________________________

ii) placed before the Board of Governors on______________

Membership intimated on

Individual Membership Form

Printer Friendly Institutional Membership Form