Bihar Social Enterperneurs Association

3rd Floor, Jagdamba Tower, Sahdeo Mahato Marg, Boring Road, Patna, Bihar, Ph : +91 612 2540330,
Email Id: info@bseaindia.com, Website: www.bseaindia.com

Form No :
Date:

Membership Form

Name of Venture :
Name of MD/Owner/Chairman :
Brief Profile Of Member (For Website and Brochure) :
Address :
Sector :
Website & Email Address :  Contact Nos :
Office Photograph :  
Registration No. (Furnish Copy of Certificate, Bylaws) :
Type of Organization :   NGO    LLP    Pvt Ltd    Ltd. Producer Company Patenership Proprietorship
Detaisl Of Directors / Partners :
Account Details :
Services Interested :
  Tender/Business Information 
  Training 
  Workshop 
  Networking 
  Exposure Visit 
  Holiday Tours 
  Loan 
  IT & ITES 
  Patent 
  Grant 
  Incubation 
  Mentorship 
  Legal 
  Financial 
  Advertisment 
  All Services 
Any other than listed :

Hereby, i declare all the information provided is ture and i take all responsibility of the furnished details, i authorize association to represent my organization in all policy decisions, activities of association and in all dialogues/initiatives with Government & private clients. In case of any change, I will inform association president over email or letter.

FOUNDERS

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