Lucknow Management Association Photograph



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Lucknow Management Association

Photograph



(Affiliated to All India Management Association)

Scientific Convention Centre, 1 Shahmina Road, Chowk,

Lucknow 226003, Tel: 0522-2258678,8687577480

INDIVIDUAL MEMBERSHIP APPLICATION FORM


www.lmalucknow.in, Email: lmalucknow2016@gmail.com

(Application for Life Membership/Annual Membership)




  1. Name (Mr. /Ms.) ………………………………………DOB…………… Age: ….. Marital Status: …………...

Name of the Spouse & Qualification………………………………………………………………...


  1. Address :

Home Address

Office Address

Phone No (office) :

Phone No (Res.) :

Mobile :


Fax :

Email :











  1. Current Organization …………………………………………… Designation ……….…………………….…...

If Retired:

Last Organization ………………………………………………. Designation ………...………………………..




  1. Type of Organization : Under Central Govt./State Government/Public Sector/Private Sector/Defence Services/Bank & Financial Institution/Small Scale Sector/Multinational/Others (specify)…………….………...

  2. Nature of Business of your Organization: Manufacturing/(Marketing-Sales)/Banking Services/Public Utility Services/Consultancy/Teaching/Defence/Others (specify)………………………………………………………..

7. Qualification:




Degree Name

Year

University/Institute

Specialization

Graduate Degree













Post Graduate Degree













Doctoral Degree













Any Other













Publications if any…………………………………………………………………………………………………..…

  1. Experience: Total job experience (in years): ………………….

Organization

Year From

Year To

Designation

Location


































  1. Area of Activity where you would like to contribute: Pl see list of Forums/ Working groups ……………………………………




  1. What services you expect from LMA……………………………………………………...……………………...




  1. DD/Cheque No. …………Dated ……… Enclosed for Rs.5000/- (life) / Rs.1000/- (annual) membership in favour of Lucknow Management Association. Additional Rs. 500/- for Spouse Life Membership and Rs.100/-Spouse Annual Membership. (Plus GST @ 18%)

Signature of Applicant …………………………..



______________________________________________________________________________________________________________

For office Use Only

Recommended by: ED/GM Signature: Date:…………………..Receipt No……………


Approved/ Not Approved
Treasurer Secretary Vice President Sr.Vice President President


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