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Central Office Address: 3, Upper Gr. Floor, Samruddhi Venture Park, Marol MIDC, Nr. Hotel Tunga
Paradise, Andheri (E), Mumbai - 400 093. INDIA.
Ph: 022 - 6677 0218 / 19 / 6667 4444 | Fax: +91 - 22 - 2874 3543 | Email: youngceoindia@vsnl.net |
Web: www.youngceoindia.com
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MEMBERSHIP APPLICATION FORM
Name of the Entrepreneur
Date and place of birth
Designation
(Proprietor / Partner / Director /
Chairman / MD)

Business Activities

Do you own a family business

 Manufacturing  Trading  Exports /
Type of Company / Organisation Imports
 Service Provider  Others
 Proprietorship  Partnership  Private
Limited
Company / Organisation Registered as a
 Limited  Others
Date of Commencement of business:

Correspondence Address

Tel. 1. Tel. 2.
Contact Details Fax: Mobile No:
E-mail: Website
Turnover of Company for last 3 years
(in Rs./Lacs)
Export Turnover in US Dollars / Other
Currencies
Do you provide any other services?
(Give details)
Certification(s) Obtained (ISO: 9000
etc.)
Name and address of the Bank (s)
Provide Information on Joint Ventures /
Technology
Transfers / Contract Manufacturing
Support Services needed from the
Forum
(provide detailed list on company letter
head)
We are interested to involve actively in
the activities  YES  NO
of the Forum
Are you involved in any activities
pertaining to development of Young
Entrepreneurs, if so; provide details on
your letterhead.
Do you need finance, marketing or
other business development support
from the Forum, if so, provide details
on your letterhead.
Provide information about your success
story or major achievements
( including innovations)
Are you a recipient of any Awards
Are you member of any other Chamber,
Forum and Association ( provide
details)
 MEMBERSHIP CATEGORIES & FEES
Sr. Membership Who Can Apply for Membership? Annual
No Category Membership Fees
I Ordinary SMEs, Manufacturers, Pvt. Ltd. Cos. , Rs. 7,500/-
Member Micro
Exporters, Importers Traders,
Commission Agents, Professionals,
Buying Agents, Distributors
II Associate Any individual and Professionals Rs. 7,500/-
Member
III Corporate Representative of Public Limited & Rs. 30,000/-
Member Multinational Companies, International
Organisations and Companies
IV Institutional Banks, Financial Institutions, VC/PE Rs. 30,000/-
Member Firms, HNIs, Factoring Company,
Insurance , Credit Rating Agencies,
V Patron Member Any Individual / Organisation can apply Rs. 3,00,000/-
for Patron Membership ( Forum reserves (One time
the right to accept the membership) - subscription)
valid for Five years
VI Honorary By Invitation Only No fee
Member

I wish to apply for the membership and submitting herewith information about my / our
Business Activities. Category of Membership
(__________________________________________________________________________________________________________
_________).

I am / we are attaching herewith the membership fee vide Cheque / Demand Draft No.
____________________Dated _______________for Rs._________________________/
Rupees__________________________________________________________________________________ drawn on
Bank _______________________________________________________________________Branch
__________________________
(DD / Cheque should be drawn in favour of “INDIAN YOUNG ENTREPRENEURS’ FORUM”,
Mumbai”).

I / We confirm that the above furnished information is true and correct. I / We agree to abide
by the rules and regulations of the Forum as amended from time to time. I / we assure that I /
We will participate in the activities and various programs organised by the Forum.
Yours sincerely,

Applicant's Signature (with Company Seal) Name: __________________________ Designation:

________________ Date: ___________

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Please enclose the following along with Membership Application Form

 Membership Fees by Cheque / D. D (no cash)
 Two Sets of Company Profiles (Print & Soft Copy)
 Photocopy of Company / Business Registration Certificate Two Photographs of Applicant

Important Notes / Terms & Conditions:

 Acceptance / refusal of membership will be at the sole discretion of the Managing Committee of
the Forum.
 The Forum reserves its rights to accept or reject the membership without assigning any reason
thereof.
 No refund will be given for cancellation of membership for any reason whatsoever.
 Incomplete Application Forms and those do not fulfill the above requirements will not be
accepted.

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FOR OFFICE USE ONLY - MEMBERSHIP APPROVAL

Membership Category _________________________________ Membership No. ________________ Date of

Approval _________________

Recommended by ______________________________________ Approved by

___________________________________________