Membership

IMA SILVER MEMBERSHIP FORM

Individual Membership Fees- Rs 6000 /- (Additional Entrance Fees Rs 1000/- & GST @18% )
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Name :
Name Of Organization:
DOB:
City :
GST No. :
State :
Postal Code :
Telephone No. [Local] :
Mobile No. :
Correspondence Address:
Email:
How did you come to know IMA?
Office
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Couple Membership [Membership Fees- Rs 5900 /- (including Entrance Fees Rs 500/- And GST @ 18% )]

Name
Mobile
Organization
Email
Any Reference (Suggest friend's contanct details for membership)

First Reference
Name
Mobile
Organization
Email
Second Reference