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    Application Form For Associate/ Individual Membership

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    shan1009
    This document is an application form for individual or associate membership of the Indian Council of Arbitration. It requests information such as the applicant's personal details, education qualifications, experience, areas of specialization, and membership of other organizations. For associate membership, the form asks for details of the applicant's company such as annual turnover, number of employees, and nature of business activities. The form must be submitted along with payment of the appropriate membership fees and copies of identity documents.

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    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd

    Application Form For Associate/ Individual Membership

    Uploaded by

    shan1009
    43 views2 pages
    This document is an application form for individual or associate membership of the Indian Council of Arbitration. It requests information such as the applicant's personal details, education qualifications, experience, areas of specialization, and membership of other organizations. For associate membership, the form asks for details of the applicant's company such as annual turnover, number of employees, and nature of business activities. The form must be submitted along with payment of the appropriate membership fees and copies of identity documents.

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    This document is an application form for individual or associate membership of the Indian Council of Arbitration. It requests information such as the applicant's personal details, education qualifications, experience, areas of specialization, and membership of other organizations. For associate membership, the form asks for details of the applicant's company such as annual turnover, number of employees, and nature of business activities. The form must be submitted along with payment of the appropriate membership fees and copies of identity documents.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    43 views2 pages

    Application Form For Associate/ Individual Membership

    Uploaded by

    shan1009
    This document is an application form for individual or associate membership of the Indian Council of Arbitration. It requests information such as the applicant's personal details, education qualifications, experience, areas of specialization, and membership of other organizations. For associate membership, the form asks for details of the applicant's company such as annual turnover, number of employees, and nature of business activities. The form must be submitted along with payment of the appropriate membership fees and copies of identity documents.

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    © All Rights Reserved
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    (Registered under the Societies Registration Act, 1860)

    Federation House, Tansen Marg, New Delhi-110001.


    Tel: 23487426/25, 23350087, 23719103, 23319849, 23738760 Fax: (91) 11 23320714, 23721504
    Website: www.icaindia.co.in Email: ica@ficci.com and membership.ica@ficci.com

    APPLICATION FORM FOR ASSOCIATE/ INDIVIDUAL MEMBERSHIP

    Category of Membership:
    Passport Size Photo
    Individual Member  Life Individual Member 
    Full Name: Mr./Ms/______________________________________________________________________________
    (in Block letters)
    Address:_______________________________________________________________________________________
    ______________________________________________________________________________________________
    _______________________________________________________________________Pin____________________
    Occupation:____________________________________________________________________________________
    Phone/s: (Office)__________________________(Resi.)_______________________ ___Fax:_________________ (One extra photo to be submit)
    Email:_________________________________________________Mobile:______________________________________________________
    Date of Birth:__________________________________________________Age:__________________Nationality:______________________
    Father’s/Husband’s Name:______________________________________________________________________________________________
    (Please attach supporting documents for the purpose of office records)

    Educational/Professional Qualifications (Graduation onwards):


    Name and Address of College/Institution University Year of Passing
    _____________________________________________________ _______________________________________ _____________
    _____________________________________________________ _______________________________________ _____________
    _____________________________________________________ _______________________________________ _____________
    (Please attach supporting documents for the purpose of office records)
    Experience:
    Employers’ Name Address Position Period
    From To
    ______________________________ ________________________________ _______________________________ ___________ _________
    ______________________________ ________________________________ _______________________________ ___________ _________
    ______________________________ ________________________________ _______________________________ ___________ _________
    ______________________________ ________________________________ _______________________________ ___________ _________

    Members of the following:


    Organisations Position Period
    From To
    ____________________________________________ ___________________________ ____________ ____________
    ____________________________________________ ___________________________ ____________ ____________

    Are you already a Member (Annual Basis):_________________________________________________

    Fields of Specialization:

    Please tick (  ) your experience or knowledge:

    Agency & Distribution and Franchising / Engineering/Technical / Intellectual Property / Joint Ventures / Real Estate / Power Energy /
    State Contracts /Aviation / International Investments /Finance Banking /Maritime Shipping /Commercial Contracts  /Telecommunications
    /Construction /Insurance /Information Technology /Oil, Petroleum and Gas /Securities /Steel, Mining & Quarying /Corporation & related
    activities /Agriculture & Food Processing /Hotel & Tourism Industry /Automobile /Entertainment /Corporate Law /Environment /Taxation
    /Transport /Textile/Jute Industry /Computer Software / Other Areas /Specialisation & Knowledge of any other
    field:____________________________________

    Arbitration:

    Course Name Organizer’s Name Period

    Arbitration: As Arbitrator

    Number of Cases as a Sole/Co-Arbitrator:


    Number of Cases as a Counsel/Expert witness:

    Field(s) of arbitration:

    Name of Seminars/Conferences participated:


    Addressed

    1
    Participated

    Title of Paper presented (Enclose a set of Paper)


    Whether willing to contribute or
    make presentation in Conference on ADR
    or for ICA Arbitration Quarterly

    Existing Membership of Chamber/any Association (This information is vital).

    I am a member of _____________________________________________________________________________________________________

    Sponsorship (Optional) by: ICA Member/Local Chamber/Bank Manager

    Name:__________________________________________________ Signature & Stamp:___________________________


    Designation:_____________________________________________
    IN CASE OF APPLICATION FOR ASSOCIATE MEMBERSHIP, PROVIDE THE FOLLOWING INFORMATION:

    Category of Membership:

    Associate Member  Permanent Associate Member 


    Name of the Company/Firm____________________________________________________________________________________________
    Name of the Chief Executive:___________________________________________________________________________________________
    Designation:_________________________________________________________________________________________________________
    Address:____________________________________________________________________________________________________________
    ___________________________________________________________________________________________________________________
    City__________________________________________________________________Pin____________________
    Phone/s: (Office)________________________________________________________________Direct________________________________
    Fax:_________________________________________ Email:_________________________________________________________________

    We are engaged in Trading/Manufacturing/Construction/Hotel/Information Technology/ Investment/Leasing/Hire


    Purchase/Banking/Merchant Banking/Portfolio Management/ NBFC’s/Insurance/Marketing/Brokering/Safe Deposit/ Travel
    Agency/ Transport/ Printing and Publishing/Cold Storage/ Research/Consultancy/Management/ Training/ Auditing/Legal
    Firm/Institutional/ Commission Agency/Agency Business:
    Main Line of Business:………………………………………………………………………………………………………………………………..
    Latest Turnover in the Year……………………………………………………………..Rs……………………………………………………….
    We are a Manufacturer/Merchant exporter and have the status of an Export House/Trading House/Star Trading House/ Super Star Trading
    House/E.O.U. /E.P.Z. 

    Export Turnover: $………………………………………………………………………..Year………………………………………………………


    Major Export Markets………………………………………………………………………………………………………………………………….
    No. of Employees (Approx.)………………………………………………………Year of Establishment………………………………………
    Location of Major Factories……………………………………………………………………………………………………………..
    Attach copy of Articles of Association/Memorandum of Association/Partnership Deed in case of Companies/Firms & latest financial Accounts
    including Balance Sheet .
    I agree to abide by the Memorandum and Articles of Association and the Rules of the ICA. I am sending herewith a Cheque/Demand Draft
    payable at Delhi in favour of ‘Indian Council of Arbitration’ bearing No.______________ dated__________ for *Rs .___________ being
    annual subscription/Permanent Associate/Life Individual Membership Subscription including one time Admission fee and GST @ 18% .
    Yours truly,
    Date
    Signature of the Applicant
    Name and Designation
    ______________________________________________________________________________________________________________________
    Rates of Subscription:

    One time admission fee and 18% GST will be charged extra on every payment and each category with effect from 1 st July, 2017.

    I. Associate Membership: (For Companies, Firms) Rs.2,950/- per annum


    (a) Annual - Rs.2,500/- +Rs.500 One time admission fee = Rs.3,000+ GST Rs.540 = Total Rs.3,540/-
    (b) Permanent - 12 times the annual subscription in lumpsum Rs.30,000+Rs.500+GST Rs.5,490 = Total Rs.35,990/-

    II. Individual Membership: (For Individuals) Rs.1,180/- per annum


    (a) Annual -Rs.1,000/- per annum+Rs.300+GST Rs.234 = Total Rs.1,534/-

    (b) Life:- below 60 years of age- Rs.1000x12= Rs.12,000+Rs.300+ GST Rs.2214 = Total Rs.14,514/-
    Life:- above 60 years of age- Rs.1000x6= Rs.6,000+Rs.300+GST Rs.1134 = Total Rs.7,434/-

    (c) Life Individual Membership fee in lump sum (Foreign Nationals) US $600 + one time admission fee of US $ 100 = Total US$700

    (d) Please provide copies of PAN Card, Aadhaar Card and two passport size photographs.

    Note: The period for Annual subscription is from 1st April to 31st March. Those applying on or after 1st October of the year need to pay only
    half the annual subscription.
    For further details, please refer to the Rules and Regulations of the Council (Rules 3 to 8)

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