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.1,00,000/-(Rupees One Lakh) only by Cheque / Bank Draft drawn in favour of Institute of Rail Transport, New Delhi.