NATIONAL SAFETY COUNCIL OF INDIA

APPLICATION FORM FOR CORPORATE TRADE UNION MEMBERSHIP

New Membership

1) Name and full address of the Trade Union
Address
2) Name and Designation of the
(a) Chief Office Bearer(President/General Secretary)
(b) Person to whom NSC Services are to be sent
3) Sector of Industry in which Union is organised
4) Whether affiliated to Central Trade Union Organisation If yes, Name of the Federation and the address
Yes No
5) Whether affiliated to Industry level Union Federation. If yes, Name and address of the Federation
Yes No
6) Whether any Cell/Committee on Occupational Safety and Health is formed in the Union. If yes, name of the Office Bearer incharge
7) Name and address of other sister Unions and their Chief Office Bearers
 
8) Select Membership fee Category
Category Annual Subscription(Rs.)
Membership Fee
I) Membership less than 3,000 Rs. 800.00 (GST 18%) Rs. 144.00 Rs. 944.00
I) Membership more than 3,000 Rs. 1,050.00 (GST 18%) Rs. 189.00 Rs. 1,239.00
9) Membership Strength of the Union
10) Membership Fee to be paid to the Council (based on the number of Members)

(Annual Subscription)
11) Payment Option (In favour of National Safety Council)

Check/Demand Draft along with copy of this duly filled-in form to be sent to
The Director General, National Safety Council
Plot No.98-A, Institutional Area,
Sector 15, CBD Belapur,
Navi Mumbai - 400 614

(mm/dd/yyyy)