IMM membership form

Executive President
Institute of Marketing & Management
B-11, Qutab Institutional Area,
New Delhi-110016

Dear Sir

I/We desire to become member of "IMM CENTRE". I am/ we are sending herewith cheque/ draft favoring "IMM" payable at New delhi for
US$ / Rs. towards registration along with lumpsum Entrance Fee for Organisation/ Individual Fee for Annual/Life Category. My/our details are as follows:

Please tick:

Organisation

Individual member

Name
Date of Birth
Place of Birth
Present Position/ Vocation
Name of Organisation
Organisation's Business		Area of Specialization
Address (Office)
Phone		Fax
E-mail
Address (Res.)
Phone		Fax
E-mail

NOTE: Filled printout of this form can be sent along with fee (Cheque/DD)