Western India Corrugated Box Manufacturers Association

Application Form

WESTERN INDIA CORRUGATED BOX MANUFACTURERS ASSOCIATION 138, Mittal Industrial Estate No. 3 M. Vasanji Road Andheri (E), Mumbai � 400 059. India . Mumbai - Tel: 91 -22 -2850 0687 / Fax: 91 -22 -2850 4523 Email: wicma@wicma.com Dear Sir, I / We desire to be enrolled as a member of your Association and remit herewith a sum of
Rs. (Rupees only) by
Cheque/D.D.No. Dated On ( Name of the Bank )
Towards Admission Fees & Subscription as well as R & D Contribution for the year ( year)
I / We agree to abide by the Rules and Regulations and the Constitution of the Association in force and also that may be amended / revised from time to time. Yours faithfully

Name of the Applicant :
Address of the Applicant :
Place :	Date :

  Notes :
  1. Association's administrative year is from 1st April to 31st March and the Subscription will have to be paid for the full year.
  2. The following amount is required to be remitted along with the application for Membership.

Admission Fees :	Rs. 1500
Subscription :	Rs. 2500
R & D Contribution :	Rs. 100
Service Tax @10.3%:	Rs. 422
Total :	Rs. 4522
* Outstation Applications should accompany only Demand Drafts.
Please note that in case of new members admitted in the second half of the year i.e from October to March � Subscription will be Rs 1500/- and Service Tax will be Rs 320/-. (Admission Fee and R&D Contribution will remain the same)
The following particulars are to be filled in by the Applicant.
Name of the Manufacturing Concern :
Status:	Proprietary Partnership Pvt.Ltd.Concern
Address : Registered Office
Telephone Numbers:
Telegraphic Address:
Fax Number :
E mail :
Names Of the Propriter/ All partners / All Directors
Name & Address with Tel.no. of the Representative to be Registered with the Association
Address at which correspondence should be sent by the association
Date of establishment :
Sales Tax Numbers :
State S.T. Reg. No.:
Central S.T. Reg. No. :

List Of the machinineries ( Tick Mark The Appropriate Only )
Name Of The Machine :	Size
Paper Corrugating :	Sheet Pasting :
Rotary Creasing / Cutting :	Sheet Printing :
Punching :	Eccentric Slotting / Stiching :
Others :
List of Testing machines, if any :
Others Products manufactured :
Name & Address of Sister Concerns with products manufactured :
Name of Trade Association where the applicant is a member :
Please attach the zerox copies of purchase bills of the machinery :
Name of the member firm,Introducing the applicant