UPRFMA

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Name of Unit*

Industry Status *

Address (Factory/Enterprise) : *

Country *

State *

District *

City

Pincode*

Photo

Select chapter where your enterprise is located.*

( Whenever IIA Chapter do not exists, membership will be with IIA Head Office directly.)

Telephone No. (Office)

Mobile*

Email*

Webstie Url

CMD / MD / Proprietor / Partner / as the case may be :*

Name	Designation	Dob	Date of Anniversary

Turnover *

Enterprise Type *

Whether Exporter or Not *

Applicant Name*

Select Signature*

Password*

Confirm Password*

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