Indian Society for Quality Affix

709, Vipul Business Park, 7th Floor, Passport size

Opp: S D Adarsh Vidhyalaya, photograph
Near Tikri More, Main Sohna Road, here
Sector -48, GURUGRAM – 122018, HARYANA
Website: www.isqnet.org Email: info@isqnet.org
INDIVIDUAL MEMBERSHIP FORM
Name (Mr./Ms./Mrs./Dr.) (In capital letters
only)
Home Address
(Door No., street, Area, City, State, Pin Code:)

Pin Code:
Date of birth
Academic Qualification
Professional Experience
Current Designation
Organisation’s Name & address
Total Experience

Telephone Office
Mobile no.: Email ID:

Type of Membership Life Membership Annual Membership

Identity proof (Attach self-attested copy) Aadhar Card/ Pan Card/ Driving License/ Passport / Voter ID
Serial Number:
Introduced by
Name of the member :
Membership No. :
Signature : Signature of Applicant Date:
Payment Particulars: Payment can be sent through Draft/Cheque/Net-banking Amount in Rs.
Cheque /Draft or Net-banking (RTGS/NEFT/IMPS/) ref. No.
Date: Issuing bank:
Details of ISQ Account for Net-banking : Account Name : Indian Society for Quality Bank Account No. : 00272000001288
Name of the Bank : HDFC Bank Branch : Greater Kailash
IFSC Code : HDFC 0000027
Membership Entrance Fee in Membership fee in GST in Total
Annual 100.00 500.00 108.00 708.00
Life 500.00 5000.00 990.00 6490.00
Student (Annual) 50.00 250.00 54.00 354.00
For Office Use Only
The membership is approved for registration by the Governing Council. Registration/
Membership
Number:
Signature of President