Vidharbha Trainers

Membership Registration Form

Name ^*

DOB ^*

Blood Group^*

Email Address ^*

Company name (optional)

Company Email Address

Company Address

Nature of Business ^*

Phone ^*

Address ^*

I Desire to be a member of “ VIDHARBHA TRAINERS ASSOCIATION OF INDIA I undertake to abide by the Rules & Regulations of the Trust and declare that the information in this form is true.

Cheque No ^*

Bank Name ^*

Branch Name ^*

Date ^*

Received By ^*