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Online Application Form - Online Payment

Membership Charge :USD 100 or Rs. 5000

The Infomediary Services can be availed on membership basis. Mambership fee is to be paid by Demand Draft in favour of "NSIC Ltd" payable at the city of your nearest NSIC office.

Infomediary Services
Membership Application Form

Renewal

New

Document Ref: F: ITEC:01
Edition No.: 02
Page No.: 01 of 01

Issue Date : 16 - 07 - 2007
Issue Control Authority : Head,
Infomediary Services, H.O.

Places of Use: HO / ZO / RO / BO / SO
/ NTSC / NTSEC

Name of Company :

M/s *

Name of CEO/MD

Address :

City:

State

Country

Pin :

Email :

Mobile No :

Website :

Phone :

Fax:

Whether SSI : ( PI. Tick)

Yes

Activities : ( PI. Tick)

Manufacturer

Trading

Services

Main Customers
( Optional )

Product (s)/Services:

Year of Establishment:

Employment

Turnover in Rs.

Certification ( if any) e.g. ISO, QS, BIS. Etc.

Are you an Exporter ( Pl. tick)

Yes

If Yes, Countries exported to:

since ( Year ) Products / Services exported:

Give a Breaf background and details of your company (Attach separete sheet if necessary)

Are you looking for any kind of cooperation as given below? ( Pl. Select)

	Offerring Technology
	Looking for Technology
	Looking for Co-production Opportunity
	Distributorship
	Looking for Sub-contracting Oppertunities
	Product selling
	Product Buying

Countries where you have current potential business interest

Write five of your Products/services ( Optional )

The National small industries corporation ltd.
NSIC Bhawan , Okhala Industrial Estate, New Delhi - 110020
Ph: 91 - 11 - 2692675, 26927502, 1800111955 ( Toll free no), Fax : 91 - 11 - 26927160,
Website: http://www.ncic.co.in, Email: info@nsic.co.in