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Term Membership
Category of Member   
I am / We are desirous of enrolling as a Term member/s as per Rules & Regulation of MACCIA.
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Membership in the name of  *   
Membership Category  *

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Postal Address for Correspondence *
City *
Region *
State *
District *
Country *
Pin Code *
Telephone No. (Office) *
Telephone No. (Residence) 
Fax No.
Mobile No. *
Email ID 
Additional Email ID 
Website
Pancard No 
Pancard Scan copy 
Photo 
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Full Name of the Representative *   
Designation
Mobile No.
Residence No.
Nature of Business Category
Trade


Industry
Agriculture
Professional


Manufacturing


Financial Institute
Transport
Media & Research
Association


Services
Other


Please specify your activity in brief, to help us for your exact classification:
Product
Services
Payment Details
Cheque should be drawn in favour of  Maharashtra Chamber of Commerce, Industry & Agriculture
Payment Mode
In case of Company the paid up capital plus reserves as per Previous Year Balance Sheet was Rs.   and Total Assets Rs.  (in case of Bank)
Balance Sheet of Last Year    :-      
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