Registration Form

Membership Type:	CorporateIndividual
Membership Fees:	Naira 0.00
Company/ Member Name:
Date of Incorporation:
Address of Registered Office:
Address for Correspondence:
Tel No:
Fax:
Email:
Industry Type:	AdministrationAdvertisingAgriculturalArchitectureArt and AntiquesAutomotive IndustryAviationBankingBeautyBuilding and ConstructionBusiness ServicesCAD/CAMCall CentresCharityChefsChemicalChildcareCivil EngineeringCivil ServiceCommercialCommoditiesCommunicationsComputer and ITConservationConstructionCustomer ServiceDairyDefenceDesk Top PublishingDistributionDoctorsDomicilary CareDraughtingDriversEducationElectrical EngineeringElectronicsEmergency ServicesEngineeringEnvironmentEstate Agents and ManagementFacilitiesFashionFilms and TVFinancialFranchisingGames and Interactive EntertainmentGraphic DesignHardwareHealth and SafetyHealthcareHospitalityHousing AssociationHuman ResourcesHygieneImport / ExportInformation TechnologyInsuranceInterior DesignInterpretersInvestmentIT and CommunicationsJournalismLaboratoryLibraryLogisticsManagementManufacturingMarineMarket ResearchMarketingMediaMedicalMerchandisingMiningMusicNanniesNuclearNursesOil and GasOnline RecruitmentPensionsPersonal AssistantsPetrochemicalPharmaceuticalProcurementProductionPublic SectorPublishing / Printing / PackingRailRetailRisk AssessmentSafetySalesScientificSecuritySocial WorkersSport and LeisureSupply ChainTechnicalTelecomsTele-MarketingTherapistsTrainingTravelUtilitiesVeterinaryWarehouseWater Treatment / Production/ BottlingWebsite/Internet
Name(s) of Company Director(s)/ Partner(s):
Name(s) of Associate/Subsidiary Companies in Nigeria and Nature of the Business:
Name(s) of Associate/Subsidiary Companies in India and Nature of the Business:
Name(s) of Associate/Subsidiary Companies in other Countries and Nature of the Business:
Full Name of the Principal Representative of the Company for this Chamber:
Designation/ Position held in the Company:
Residential Address:
Tel No:
	Will the Company Representative be able to attend Regular Meetings of the Chamber? YesNo
	Will the Representative be interested to play an active role in any of the NICCI Committees? YesNo
DECLARATION:	I/We wish to be Member(s) of Nigeria-Indian Chamber of Commerce and Industry and if admitted, to be bound by the Memorandum and Articles of the Association I/We declare that all Statements made by Me/Us on the Application Form are Current and True Accept