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APPLICATION FORM FOR LIFE / PATRON / LIFE TO PATRON MEMBERSHIP

Please enrol me as Individual Member of The Textile Association (India). I, being aware of the aims

and objectives of the Association, hereby agree to comply with the clasuses laid down in its constitution.

LIFE		Password :
Unit:

1. Name :


SURNAME	FIRST NAME	MIDDLE NAME

2. Date of Birth :

Sex

Age :

Blood Group :

Marital Status :

( Please tick one address for correspondence )

3. Permanent Address :

Mail at

PIN :

Telephone :

Fax :

Mobile :

4. Present Address :

Mail at

PIN :

Telephone :

Fax :

Mobile :

5. Organisation Address :

PIN :

6. Telephone :

( Off ) :

(Res) :

Fax :

Mobile :

E-mail :

7. Area of Interest :

Spinning / Weaving / Processing / Knitting / Garment / Research / Fashion Design / Other

8. Qualification :

	Degree / Diploma	University / Institute	Year Of Passing
1.
2.

9. Presently Working / Designation

10. Introduced By :

	Name	Membership Number	Signature
(a)
(b)

1. I have read the rules & regulation & agree to abide by them.

2. I have completed my Life Membership for Five Years & my existing No. is

Date :

Signature of Applicant

8/28/2008