FLUID POWER SOCIETY OF INDIA (Regd.

)
Unit No. S-21, 2nd Floor, #239, SNS Chambers,
Sadashivanagar, Sankey Road, Bangalore - 560080
Tele fax: 080-23600917; Mob: +91 9986504001
E-mail: fpsi.regd@gmail.com,
MEM.No.

APPLICATION FOR INDUSTRIAL / INSTITUTIONAL MEMBERSHIP

GUIDELINES TO FILL THE FORM

1.

Any Industry or Sales or Services Organization dealing in Fluid Power Products, Machinery or
Equipments is entitled to become an Industrial Member while, any academic Institution, College or
Research Organization can become an Institutional Member of Fluid Power Society of India (Regd.)

2. 1.

Please type or write clearly in block letters. Sign and put Official Seal of the organization for authenticity.
Name of the Industry / Institution & Address.......................................................................

Give detailed postal address and also Telephone Nos. both for Factory / Works / Office, Fax Numbers, Telex & e........................................................................................................................................
mail address.

3.

You..................................................................................................................................................
must promptly notify the FPSI the change of address, Telephone Nos., or change of names of Key
Tel. No.........................................Fax
.....................................................................................
Personnel
who are responsible and decisionNo.
makers
regarding.

4.

,..E-mail:.....................................................................................................................................

Subscription to FPSI

.......

2. ,..Name of the Head of Industry / Institution with Designation.

Advertisement in Fluid Power Journal of FPSI

,..
Sponsoring Staff Members to attend course work / Exhibition /

3.

Technical
Workshops
organisedActivities
by FPSI. of the Institutions.
Range of
products
of the Industry';
,..
,......................................................................................................................................................................
Individual to participate in FPSI activity on behalf of your organisation.

5. 4. Furnish
on a separate
sheet the profile
of your
organisation
range, Employee strength,
Namebriefly
of persons
representing
Industry
/ Institution
with- product
Designation
area / size of the factory, Foreign collaboration etc. Attach additional Sheets if required.
a)
6.
Furnish the proof, if you are to be considered as Small Scale Industry. (Attach a xerox copy of Certificate
OR
from Commissioner for Industrial Development and Director of Industries and Commerce):
b)
7. 5. Application should accompany the admission plus membership fee (only by a Bank Draft drawn in favour
representative
of Industry
/ Institution
stamp. in
ofAuthorised
"Fluid Powersignature
Society ofof
India
(Regd.)", payable
at Bangalore,
(Pleasewith
referofficial
details provides
application form).
8.

Signature
Seal
The membership subscription period is taken as 1st April of the year to the 31st
March ofwith
the following
Forms
without
official
seal
will
not
be
considered
for
membership
Year, no matter which month of the year you apply and get elected as a member of FPSI.

. INDUSTRIAL MEMBER

For Office Use only

. Large Scale Industries

Admission fee
Annual fee

: Rs.
: Rs.

. Small Scale Industries

Admission fee
Annual fee

: Rs.
: Rs.

5,000/
4,000/2,000/-

2,000/-

Application received on :

Grade awarded:

. INSTITUTIONAL MEMBER

Admission fee:
Annual fee :

Rs.
Rs.

2,000/2,000/-

FOREIGN INDUSTRIAL MEMBER

Admission fee:
$
150
Subscription:
$
100

Date:

Chairman of Gradation
Committee