FLUID POWER SOCIETY OF INDIA ®

Unit No. S-21, 2nd Floor, # 239, SNS Chambers, Sadashivanagar,

Sankey Road, Bangalore – 560080, Phone: 080 – 23600917
Mobile: +91 99865 04001 | Email : secretariat@fpsindia.net
Website: www.fpsindia.net GSTIN: 29AAAAT0852E1ZN
Reg. No. 280/73-74

DATE: Mem. No.

APPLICATION FOR INDUSTRIAL / INSTITUTIONAL MEMBERSHIP

1. Name of the Industry / Dealer / Institution: Maxim Hydraulics Private Limited

Regd. Office Address: #199/1, Bypass Road, Poonamalle,

Chennai, TN, INDIA, PIN 600056

GST No.: 33AAFCM6352D1ZR Telephone: 9384833469 Mobile No: 9789092560

E-mail: ram.meyyappan@Baileyhydraulics.com Website: www.baileyhydraulics.com

2. Name of the Head of Industry / Dealer / Institution (with Designation):

Mr. Mohan Kumar
Engineering Director
3. Range of products of the Industry / Dealer / Activities of the Institution:
Hydraulic cylinders, valves and Power packs

4. Name of persons representing the Industry / Dealer / Institution (with Designation):

a) Mr. Ramaswamy - Senior Manager Engineering design

Or
b)

5. Authorised Signature of representative of Industry / Dealer / Institution

with official stamp (Forms without official seal will not be considered
for membership)

For Office Use only

Application received on:

Grade awarded:
Signature with Seal
Date:

Chairman - Gradation Committee

1
Membership Fees:
NO. CATEGORY ADMISSION FEE ANNUAL FEE

a) Institutional Member (INST) ₹3,000/- ₹5,000/-

b) Micro & Small-Scale Industrial Member (SSI) ₹3,000/- ₹5,000/-
c) Medium Scale Industry Member (MSI) ₹3,000/- ₹10,000/-
d) Large Scale Industry Member (LSI) ₹6,000/- ₹25,000/-
e) Foreign Industrial Member (FIM) $150 $400

ELIGIBILITY CRITERIA

1. Industrial Member: Industries or sales or service organizations, including dealers / suppliers /

resellers of Fluid Power related products or services are entitled to become Industry members
of FPSI.
a. Micro & Small-Scale Industrial Member (SSI): Annual turnover up to ₹10 crores
b. Medium Scale Industry Member (MSI): Annual sales turnover between ₹10 crores -
₹100 crores
c. Large Scale Industry Member (LSI): Annual sales turnover above ₹100 crores

2. Institutional Member (INST): Academic Institutions or Colleges, including ITI / Polytechnic

colleges, or Research organizations.

GUIDELINES TO FILL THE FORM

1. Please type or write clearly in block letters. Sign and put Official Seal of the organization for
authenticity.
2. Give detailed postal address and Telephone Nos. both for Factory / Works / Office, Fax
Numbers, Telex, & E-mail address.
3. Completed document must be sent to the FPSI Secretariat, together with the Photocopies of
Certificates.
4. Payment details will be communicated after approval of membership by the Gradation
Committee.
5. You must promptly notify the FPSI of any change of address, Telephone Nos., or change of
names of key personnel who are responsible and decision makers regarding,
 Subscription to FPSI
 Advertisement in Fluid Power Journal of FPSI
 Sponsoring Staff Members to attend course work / Exhibition / Technical Workshops
organised by FPSI.
 Individuals to participate in FPSI activity on behalf of your organisation
6. Furnish briefly on a separate sheet, the profile of your organisation, including product range,
employee strength, area / size of the factory, foreign collaboration, etc. Attach additional
sheets if required.
7. Furnish the proof if you are to be considered as Small-Scale Industry. (Attach a photocopy of
Certificate from Commissioner for Industrial Development and Director of Industries and
Commerce).
8. The membership subscription period is taken as the financial year (1st April to 31st March),
no matter which month of the year you apply and get elected as a member of FPSI.
9. Members can access their membership account details on the FPSI website - Member Zone.