A P P E N D I X - AA

Application for Membership

( Rule 4. a. of the Rules & Regulations )
To: Date:
The Hon.Secretary,
The Indian Salt Mfrs. Association,
51-A, Mittal Chambers, 5th floor,
Nariman Point,
Mumbai - 400 021.

Dear sir, Re:- Associate Membership.

I, as an Official dignitary of ____________________________________________________
hereby apply to be admitted as an Associate Member of the Indian Salt Manufacturers’
Association, Mumbai. I have read the Memorandum and the Rules & Regulations of the
Association and hereby declare ourselves/myself bound by it and to any additions/amendments to
it and to Rules & Regulations as may be properly passed under it from time to time by a properly
Constituted Managing Committee.

The particulars/information regarding ourselves/myself are as under:-

1. Full Name:____________________________________________________________

2. Address : (1)Administrative Office____________________________________

_____________________________________________________

Tel.No.________________________Fax No._________________

E-mail _______________________________________________

3. Association’s
Registration : No__________________________ Date_____________________
( Please enclose copy of Registration )
4. Strength of
Members : _______________________________________________________

5. Total Salt production

Capacity of Members : ________________________________________________

6. Authorised representatives : (1) PRINCIPAL / PRESIDENT

Shri_________________________________
Tel.No.(Off.) _________________________
(Res.) _______________________________
Mobile ______________________________
(2) ALTERNATE / SECRETARY:
Shri_________________________________
Tel.No.(Off.) _________________________
(Res.) _______________________________
Cont’d…2
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7. Name of other
Organisations in which: _________________________________________________
we are associate Member _______________________________________________

9. Any other relevant

information the : _______________________________________________________
applicant would
like to add : ________________________________________________

( Any change in the above may please be communicated to this Association immediately)

10 Subscription: Rs.6,000=00 per annum

11 Entrance Fee: Rs.1,000=00

An Amount of Rs.____________ (In Words Rupees ____________________________________

by Cash/Pay Order/D.D. No. _________ dtd.__________ payable at Ahmedabad, drawn on

(Bank, Branch & City)_________________________________________ is enclosed / paid

herewith.

I/ We shall thank you to obtain consent from all Members of the Association as per Rule 4 of the
Rules and Regulations and convey to me/us the decision of the Managing Committee.

Yours faithfully,

Name of Applicant:
Designation:

____________________________________
(Association’s Rubber Stamp with Signature)

Proposed by Shri __________________________________________

Authorised
Representative of __________________________________________ (Sign on Stamp)

Seconded by Shri __________________________________________

Authorised
Representative of __________________________________________ (Sign on Stamp)