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Phone : 2248 5114 
Tele Fax: 2210 4075
  E-mail: fosmi@cal3.vsnl.net.in 

                       Application for Membership                                                   FOSMI                     
The Secretary                                                                                   Dt.______________

                Fedaration of  Small & Medium Industries,West Bengal
                        23,R.N. MUKHERJEE ROAD, KOLKATA - 700 001 Dear Sir,
I/We desire to become a member of Federation of Small & Medium Industries. West Bengal and agree to abide by the Rules of the Federation. I/We agree to pay Annual Subscription of Rs. 700/- and Admission fee of Rs. 300/- totalling Rs. 1000/- for which cheque/cash is enclosed.

1. Name of Unit     _______________________________________________________

2. Addrees:  Office ______________________________________________________

                 Factory_______________________________________________________

3. Name of Owners/
                 Directors______________________________________________________

4. Phone Nos.         Off.______________ Factory_______________Resi____________

5. Fax                     ______________________________Mobile___________________

6. E-mail Address   ______________________________Website__________________

7. Goods Manufactured___________________________________________________

8. Goods Exported  ______________________________________________________

9. Employment Strength___________________________________________________

10. Problems faced, if any__________________________________________________
(use separate sheet, if required)

11. S. S. I. Regn. No. ____________________________________________________

12. Whether ISO Certified_________________________________________________

13. Membership with other organizations, if any _________________________________

 

 

                                                                                 Signature______________________
                                                                                                  (Owners/Directors)
                                                                                                 (With Rubber Stamp)

Proposed by(Name of Co.)________________________________________________

Fosmi Member's Name_______________________Signature_____________________

Seconded by(Name of the Co.)_____________________________________________

Fosmi Member's Name_______________________Signature_____________________

New Membership No.____________________________________________________

 

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