Membership Form

Name of the Organization

Flat/Room/Door/Block No.

Name of Premises

Street/Road

Post Office

Area/Locality

Town/City/District

Pin code

Phone No.

Email

Website (Optional)

Others

Document Upload - GST / Aadhar / Pan Card

GST No.

Company Regn No.

Incorporation Date

Mainline Of Business

Member Photo Upload

Business Mainly

Address of Regd Office

I/We

Address

Phone

Mobile

Email

Website

Select Category

I am / we are a / an

Date of Birth

Year of establishment

My / our main activity is th field of

My / Our nature of business is

Name, Designation & Address of Proprietor /Partners / Directors (as the case may be)

I / We authorize Shri

Res. Address

Phone

Email

I am / We are remitting Rs.

being admission fee of Rs.

together with one year subscription of Rs.

for the year

vide UPI / UTR / Cheque No.

Dated

drawn on (in favour of “ODISHA CHAMBER OF COMMERCE”)

I/We understand that my / our membership is subject to approved by the managing committee / Executive body of the chamber

We have read the aims of the chamber and agree to abide by its constitution, rules & regulation in force from time to time (Memorandum & Article of Association).

Membership Form

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