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    Association of Indian Laboratories: Membership Form (Mf-01)

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    Devendrasinh Padhiyar
    This document contains a membership form for the Association of Indian Laboratories. The form requests information such as the name and address of the laboratory applying, the type of membership being applied for, payment details, and a signature agreeing to join the association. Membership options include life, regular, additional multi-location laboratory, and individual memberships, ranging in annual fees from Rs. 2,000 to Rs. 1,50,000 plus applicable GST. Upon completion, the form and supporting documents should be mailed to the provided address for processing.

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

    Association of Indian Laboratories: Membership Form (Mf-01)

    Uploaded by

    Devendrasinh Padhiyar
    32 views1 page
    This document contains a membership form for the Association of Indian Laboratories. The form requests information such as the name and address of the laboratory applying, the type of membership being applied for, payment details, and a signature agreeing to join the association. Membership options include life, regular, additional multi-location laboratory, and individual memberships, ranging in annual fees from Rs. 2,000 to Rs. 1,50,000 plus applicable GST. Upon completion, the form and supporting documents should be mailed to the provided address for processing.

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    Membership

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    Membership

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    This document contains a membership form for the Association of Indian Laboratories. The form requests information such as the name and address of the laboratory applying, the type of membership being applied for, payment details, and a signature agreeing to join the association. Membership options include life, regular, additional multi-location laboratory, and individual memberships, ranging in annual fees from Rs. 2,000 to Rs. 1,50,000 plus applicable GST. Upon completion, the form and supporting documents should be mailed to the provided address for processing.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    32 views1 page

    Association of Indian Laboratories: Membership Form (Mf-01)

    Uploaded by

    Devendrasinh Padhiyar
    This document contains a membership form for the Association of Indian Laboratories. The form requests information such as the name and address of the laboratory applying, the type of membership being applied for, payment details, and a signature agreeing to join the association. Membership options include life, regular, additional multi-location laboratory, and individual memberships, ranging in annual fees from Rs. 2,000 to Rs. 1,50,000 plus applicable GST. Upon completion, the form and supporting documents should be mailed to the provided address for processing.

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    Association of Indian Laboratories

    st
    Office Address: 113, 1 Floor, Sushant Tower,Sector-56, Gurugram, Haryana-122011
    Email: aoilsecretariat@gmail.com | Web: www.aoil.in | Regd. No: HR 018201401605

    MEMBERSHIP FORM (MF-01)

    1. Name of Laboratory………………………………………………………………………………………………………

    Address of Laboratory ……………………………………………………………………………………………………

    ………………………………………………………………………………………………………………………………

    2. Name of Laboratory Representative…………………………………………..………………………………………...

    3. Name of Alternate Representative…..………………………………………………………..………………….

    4. Field of Lab.: Medical / Testing / Calibration / GLP Laboratory…………………………….. (Tick the applicable)

    5. Legal status: Proprietorship / Partnership / Private Ltd. / Public Ltd. / LLP/Govt. Sector Firm/others

    6. PAN No.………………………………………………………..GST No…………………………………………………

    Email ……....…………………………………………………………….…………………………..……………………..

    7. Phone Number: (Office)…………………………………. Mobile………….……………………...……….………….

    8. Type of membership applied for (April to March) ……(a) (b) (c) (d) …….(Tick any one)
    a) Life Membership Fee - ₹1,50,000/- + GST @ 18%
    b) Regular Member Registration Fee - ₹ 2,000/- + GST @ 18% (One Time)
    Annual Subscription & Renewal - ₹ 10,000/- + GST @ 18%
    c) Per Additional Multi-location Laboratory Registration Fee - ₹ 2,500/- + GST @ 18%
    d) Individual Membership Registration Fee - ₹ 2,000/- + GST @ 18% (One Time)
    Annual Subscription & Renewal Fee - ₹ 2,000/- + GST @ 18%

    9. DD / Cheque / NEFT No:…………………………………………….............Date………………..…………...………

    Bank Name……………………….................Branch………………….........Amount ₹………………..,…................

    I, as the competent authority, affirm that I am willing to join the Association of Indian Laboratories.

    Date………..……… Name / Signature of Laboratory Representative………………..……………

    Please sent hard copy of: a. Copy of legal identity of lab b. 2 passport size photographs c. supporting
    document for Date of Establishment d. Company’s brief profile e. Copy of GST Certificate

    Account details of AOIL: GST No : 06AADAA9863F1ZO


    Account Name : Association of Indian Laboratories
    Banker : ICICI Bank Ltd., Sector - 21C, Faridabad, Haryana
    Account No : 630301036487,
    IFSC Code : ICIC0006303
    FOR AOIL USE ONLY
    Admission Date: ………………………. Membership No: AOIL/……...…./…..……….…

    Receipt No: ……………….:…………………. Invoice No: ……………………………………...

    Regd. Office: B-203,Vigyan Vihar, GH-19, Sector - 56, Gurugram, Haryana – 122011 (India)
    (Ver-3, 22 Dec 2018)

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