Please enable JavaScript in your browser to complete this form.Type Of MembershipAssociate MemberIndividual MemberCorporate MemberWorking Women MemberCorporate PSU MemberSelect One Option Name *FirstLastFather NameSpouse's NameSpouse (Occupation Details): Email *Date of BirthEducational/Professional Qualification:Name of the Company/ OrganizationName of the CEO/Chairman/President/ DirectorAddress for Correspondence: *Year of EstablishmentAnnual TurnoverAreas of business or professionName(s) of the Authorized Representative Directors/ CEO/ Partners /Proprietor (maximum two) . Other Organizations/ Chambers/ Associations of which a member (Please mention Names) Permanent Account No. (PAN)Award(s) received, if any or wish to highlight any special achievement (Please add extra sheet if the space is not adequate)Brief Profile (write your introduction as you would like to be printed/publish)Your objectives of joining QUADCCIBriefly mention how could you contribute to QUAD CCI and its agendaPlease acknowledge receipt of the above and confirm my/our Membership. In the event of our enrollment as a member, we shall be bound by the Memorandum of Association and bylaws and Rules & Regulations of the Association of the Chamber from time to timeDigital SignaturePlease provide one extra passport size photograph for Membership Card. Please provide self attested Copy of PAN and Voter ID/Passport. Please Pay Your Fees After SubmissionSubmit 2021-09-12