Application Form for Valuer in India by nrq20268

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									G/application form/PEATA 3rd june 2004




                                             APPLICATION FORM FOR MEMBERSHIP
To,
The Joint Hon, Secretaries,
Practising Engineers, Architects & Town Planner’s Association
Shop Nos. 4 & 5, Nagree Terraces, Plot No. 538, TPS III, Soonwala Aglary Marg,
Off. M.M. Chhotani Rd., Mahim (W), Mumbai – 400 016. Tel: 444 5998, 444 2897

I, the undersigned, would like to get enrolled as a Donor Member of PEATA. I promise, if enrolled, I will
abide by and observe the provisions of the constitution in force and that will promote the objects of the
Association as far as may be in my power. I enclose a cash/cheque for Rs._________________ in
favour of PEATA.

                                                                                    LIFE MEMBERSHIP FEE
                                                                                     AGE             FEE
       Rs.                       Admission fee.                                 20 to 40 years Rs. 5,000/-
       Rs.                       Annul subscription for current year (19   )    41 to 50 years Rs. 4,000/-
       Rs.                       Life Membership fee                            51 to 65 years Rs. 3,000/-
       Rs.                       Donor Membership fee                           66 to 70 years Rs. 1,000/-

                                                                                    (Plus Admission Fees)

                  My particulars are as follows:

1.                Name in full with surname first__________________________________________________
                                                     (Surname)    (Real Name)  (Father’s Name)

________________________________________________________________________________

2.                Office address in full:                                    Residential address

                  ___________________________                                ___________________________________
                  ___________________________                                ___________________________________
                  ___________________________                                ___________________________________

3.              Phone No.__________________ _                               Phone No.____________________________

4.              Age________________________

5.              Technical Training & Qualifications_______________________________________________

_________________________________________________________________________________

6.              Number of years of holding Surveyor’s Licence from Bombay Municipal Corporation_________

                  *Registration/Licence No.____________________                      *Registration No.________________

                  (Bombay Municipal Corporation)                                    (Council of Architecture)

                  *Zerox Copy of the Certificate / Licence / Registration attached.

7.    Practising as Architect / Structural Engineer / Town Planner / Surveyor / Valuer / Landscape
      Architect / Interior Designer or any other ___________________________________________
__________________________________________________________________________________

8.              Special field of Interest______________________________________________

9.   Membership of any other Professional Societies / Associations / Institutions with Registration nos.
___________________________________________________________________________________

___________________________________________________________________________________

Date_______________________

Signature of the Proposer________________________                               Signature of
                                                                                The Applicant______________________

Name & PEATA Membership No._________________

_____________________________________________


Signature of the Seconder_________________

Name & PEATA Membership No._____________

_________________________________________

								
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