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Full Name of the Institution:
Address for Correspondence
Tel Fax Email
Address of Head Office
Tel Fax Email
Address of the Educational Institution(s)
Tel Fax Email
Whether a
Year of Establishment
Details of Programmes Offered (for Institutional Members Only)
Nature of Business Activities (for Industrial Members Only)
Details of Institution/School Affiliation/Recognition
Name of the Proprietor/Directors/Partners/Office bearers
Name of the Chief Executive/Head
Name of the Authorised Representative(s)/Contact Person(s) (Not more than two)
Name of the organizations/Chambers/Associations of which you are a member
Category Subscription
Patron Member
(Membership for 10 years) (Life Membership)
Rs. 1,50,000/-
Pan No.
How do you expect to be benefited from the membership of the Society
Kindly acknowledge the receipt of the above and confirm our Membership.
Place Date
(Cheque/Demand Draft(s) may please be drawn in favour of “Education Promotion Society for India”)
Note Payment may please be made in favour of “EDUCATION PROMOTION SOCIETY FOR INDIA” OR be transferred/deposited in our Savings Bank Account No. 0629219 1018986, Bank: Oriental Bank of Commerce, Branch: Batra Hospital Branch, New Delhi, IFSC No. ORBC 0100629.
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