INSTITUTE OF RAIL TRANSPORT
17, Rail Bhavan, Raisina Road, New Delhi 110001

APPLICATION FOR INSTITUTIONAL MEMBERSHIP
(USE BLOCK LETTERS ONLY)

 Tel. : (011)3384171
Fax. : (011) 3384005

NAME & ADDRESS

Institution / Enterprise…………………………………………………………………………………………………………………………………

                                                …………………………………………………………………………………………………………………………………

Name of Chairman /MD………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………………

Telephone (O)…………………………………………………… E-mail……………………………………………………………………………

Mobile……………………………………………………………… (Fax)……………………………………………………………………………

Business :

(Specify Products Manufactured / Services
Offered Related to Rail Transport , if any)

Name & Address

Designation

Tel. No.

1.

2.

REPRESENTATIVES

3.

If organisation is located outside Delhi,
Address of Delhi branch, if there is one ……………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………………

……………………………………………………………………Telephone :…………………………………………………………………………

Signature :……………………………………………

  1. Organisation may nominate Two Representative(s) maximum. Any change in the employment of the representative concerned should be advised to the IRT Unit to which the Organisation is attached.

NOMINATING AUTHORITY :

Membership No……………………………………………………………………………………………………………………………………………

Note: Please make the payment of Institutional Membership Fee Rs.10,000/-(Rupees Ten Thousand) only by Cheque / Bank Draft drawn in favour of Institute of Rail Transport, New Delhi.