NATIONAL SAFETY COUNCIL OF INDIA

APPLICATION FORM FOR CORPORATE MEMBERSHIP

New Membership
1) Name and full address of the Organisation
Organisation Name
Address
Address
City
District
Pin Code
State
Country
Telephone No
Fax No
Email Address
Website
Org GST
Org Pan
2) Name and Designation of the
(a) Chief Executive/Occupier
 
Name
Designation
(b) Executive In-charge of Safety Department
 
Name
Designation
Tel No
Mobile
(c) Person to whom NSC services are to be sent
 
Name
Designation
Tel No
Mobile
(d) If your establishment is a unit of any multi-unit organisation, please give full address of the Corporate Office
 
Address
3) Category of Organisation
(a)
(b)
(c)
(d)
4) Whether the Organisation is a part of a Multi - National Company
5) Whether the Organisation is a Major Accident Hazard Installation
6) Main Product(s) manufactured/Activity undertaken/Service offered
7) Electoral Constituency
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