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2. Name: Individual / Contact person in case of category 4:

QUALITY CIRCLE FORUM OF INDIA. Photo for Individual Life Members only. APPLICATION FOR MEMBERSHIP (Please write down in capital letters, carefully). Type of Membership : Category No:___________________________________

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2. Name: Individual / Contact person in case of category 4:

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  1. QUALITY CIRCLE FORUM OF INDIA Photo for Individual Life Members only APPLICATION FOR MEMBERSHIP (Please write down in capital letters, carefully) • Type of Membership : • Category No:___________________________________ • (Refer our membership tariff attached for details of category and write down your category) • 2. Name: Individual / Contact person in case of category 4: • __________________________________________________________ • 3. Designation:_______________________________________________ • 4. Organisation:______________________________________________ • 5. Address for Correspondence (Official address for category - 4): • ___________________________________________________________ • ___________________________________________________________ • ___________________________________________________________ • Area Code: _______ Phone. No. ______________ Fax:____________ • Mobile : ________________E-Mail: _____________________________ • Fee Details: Cash / Chq No: ________________ Date : ____________ Bank:_________________________________ Amount: ____________ • for Admission Rs. ________ + Membership fee Rs. __________ for one year/five years (by paying four years subscription for category – 4) • (Cheque should be drawn in favour of Quality Circle Forum of India payable at Pune ) • Date : ______________ Signature______________________ • (For Office use only) • Receipt No. Date: M/Ship No. • Please send your duly filled application form to the following address: • QUALITY CIRCLE FORUM OF INDIA • Quality Circle Excellence Centre. J/P-10, MIDC , Telco Road, • Bhosari, Pune - 411 026. 020-46768768 • Email: qcfipc@gmail.com

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