Application Form For Channel Partners


    PLEASE FILL IN CAPITAL LETTERS


    M/S _________________________________________________________

    NAME  (Dir/Prop.) _____________________________________________ FATHER’S NAME _____________________________________________

    OFFICE ADDRESS 
    ______________________________________________________________________________

    (TELEPHONE NO.)________________________  (Mobile No.)___________________________

    RESIDENTIAL ADDRESS 
    ______________________________________________________________________________

    (TELEPHONE NO.)________________________  (Mobile No.)___________________________

    E-MAIL _________________________________________ PAN/GIR NO._____________________

    NO. OF YEARS IN CURRENT BUSINESS :                                          

    CHEQUE TO BE GIVEN IN FAVOUR OF________________________________________________

    SIGN. Of AUTHORISED ASSOCIATE ________________________

    NAME OF THE AUTHORIZED ASSOCIATE  ________________________                                               


    FOR OFFICE USE ONLY

    ASSOCIATES  CODE:


    NAME _________________________________

    DATE OF REGISTRATION: ________________REGD. BY_______________________________

    ______________________(AUTH. SIGN.)¬¬¬¬¬¬¬¬¬¬¬¬¬-

    ____________________________________________________________________________________
    Noida Office No.16-17, C-Block Market, Sector-41, Noida-201 303 (INDIA)