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GREENTECH
FOUNDATION
811,Vishwadeep Tower, Distt. Center,
Janakpuri, New Delhi-110058, India
Phones : 91-11-25593846, 25554739, 25540482,
Fax : 91-11-41588564, 25612025
E-Mail : mail@greentech.org
Web site : www.greentech.org
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MEMBERSHIP
FORM
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| Company Name
: ___________________________________________________________________________________ |
| Address
: _________________________________________________________________________________________ |
| City : ______________
ZIP / PIN Code :_______________Country :_______________Website :___________________ |
| Board
of Directors (Attached list with addresses)__________________________________________________________
|
| Products / Services
:_________________________________________________________________________________ |
| Established
in Year :_________________Annual Turnover :_______________No. of Employees
:___________________ |
| Chairman cum Managing Director |
| Name__________________________________________ |
| Designation_____________________________________ |
| Phone_____________________Fax_________________ |
| Mobile______________Email_______________________ |
| Additional contacts : |
| Name__________________________________________ |
| Designation_____________________________________ |
| Phone_____________________Fax_________________ |
| Mobile______________Email_______________________ |
|
| Head of Environment |
| Name__________________________________________ |
| Designation_____________________________________ |
| Phone_____________________Fax_________________ |
| Mobile______________Email_______________________ |
| Additional contacts : |
| Name__________________________________________ |
| Designation_____________________________________ |
| Phone_____________________Fax_________________ |
| Mobile______________Email_______________________ |
|
| Head of Fire, Safety
& Security |
| Name__________________________________________ |
| Designation_____________________________________ |
| Phone_____________________Fax_________________ |
| Mobile______________Email_______________________ |
| Additional contacts : |
| Name__________________________________________ |
| Designation_____________________________________ |
| Phone_____________________Fax_________________ |
| Mobile______________Email_______________________ |
|
| Head of Human Resources (HR)
/ Personnel |
| Name__________________________________________ |
| Designation_____________________________________ |
| Phone_____________________Fax_________________ |
| Mobile______________Email_______________________ |
| Additional contacts : |
| Name__________________________________________ |
| Designation_____________________________________ |
| Phone_____________________Fax_________________ |
| Mobile______________Email_______________________ |
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|
| Location
Information : |
| If this membership
application is for more than ONE location / Unit / Factory / Project and
/ or Offices other than the locatio mentioned above, please mention the
number and name of the other locations :___________________________ |
| __________________________________________________________________________________________________ |
| Membership
Fee : |
|
Period
|
Indian Companies
|
Overseas Companies
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One Year
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Rs.15,000/-
|
US $ 500
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Two Years
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Rs. 29,000/-
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US $ 950
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| Payment : |
| The Membership
Fee is payable by way of Demand Draft drawn in favour of 'Greentech Foundation'
payable in New Delhi, (India). |
Date
: ____________________ Seal of Company___________________ Signature
with : ______________________
Name
& Designation |