Ladies Member Registration

Personal Contact Details
Entries marked with * are compulsory
Name *
Title *	Miss   / Mrs.   / Ms.
Address *
City *
Pincode *
Telephone (1) *	-  -
Telephone (2)	-  -
Fax
Email *
Blood Group	-------- Choose --------   O Rh+ O Rh- A Rh+ A Rh- B Rh+ B Rh- AB Rh+ AB Rh-
Date of Birth	(mm/dd/yyyy)
Wedding Anniversary	(mm/dd/yyyy)
Your Interests and Hobbies
Community Service undertaken

Educational and Professional Details
Academic Qualifications	-------- Choose --------   Matriculation Higher Secondary Diploma Graduate Post-Graduate Doctorate Other
Profession (Compulsory)	-------- Choose --------   Academic/Education Accountancy Advertising/Public Relations Architecture Banking/Finance Beauty/Personal Care Bilingual/Translation Biotechnology Business Supplies/Services Chemistry Clerical/Administrator Computer Hardware Consumer Retail/Wholesale Counselling Customer Support Employment/Placement Agencies Engineering/Construction Entertainment Industry Entrepreneur Environmental Executive/Manager Fashion Design Government Hospitality/Travel Housewife Insurance Interior Decoration Internet related Law Manufacture/Distribution Media/Publishing Medical/HealthCare Non-Profit Organisations Others Photography Research/Development Sales/Marketing Software Engineering Sports/Fitness Trades/Crafts
Professional Details

If you are an Entrepreneur, fill the following details
Company Name
Nature of Business
Size of Business	(No of Employees)
List 5 products of your company
(1) Product Name
Price Range (in Rs.)
Product Details
If product was exhibited, where ?
(2) Product Name
Price Range (in Rs.)
Product Details
If product was exhibited, where ?
(3) Product Name
Price Range (in Rs.)
Product Details
If product was exhibited, where ?
(4) Product Name
Price Range (in Rs.)
Product Details
If product was exhibited, where ?
(5) Product Name
Price Range (in Rs.)
Product Details
If product was exhibited, where ?

Membership Details
Membership Type preferred	Life   Ordinary (Annual)
Name of Reference Member (1)
Telephone of Reference Member (1)	-   -
Name of Reference Member (2)
Telephone of Reference Member (2)	-  -
Would you like to volunteer for IMC work?	Yes   No
If yes, in what way can you help the  IMC Ladies Wing ?
Any other details you would like us to know

Call of the Peacock 2006 in Hongkong
Preview:
6th September 2006
Exhibition:
7th & 8th September, 2006
Venue:
Holiday Inn Hotel, Kowloon
View Photogallery

Women Entrepreneurs 2006 In Mumbai
Exhibition:
10th & 11th October 2006
Venue:
Banquet Hall, Taj President
View Photogallery

The membership of IMC Ladies' Wing is over 1400 consisting of entrepreneurs, professionals and women from business families.

The Ladies' Wing has restared collection of unexpired but useable medicines which are distributed to the needy by the following institutions :
1. Yusuf Mehrally Centre
2. Sanjivani

Members are requested to kindly deposit unexpired but useable medicines in the box placed at the entrance of the Indian Merchants' Chamber.