Membership Form

Step 1 – Make a Payment

Please pay the payment through NEFT or Google Pay (Using Bank Transfer Option) or directly deposit to our Account mentioned Below

Payments will have to be made in favour of
Puthiya Thalaimurai Foundation
Bank : Indian Bank, G.N. Chetty Road Branch, Chennai
A/c No: CA 6151364008 | IFS CODE – IDIB000G079

Step 2 – Register Below as a Member

Note: Make sure you enter the payment date, receipt and Bank number details in this form.

Bank Deposit Details

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Company Name*(required) *

Payment Receipt No*(required) *

Bank Details *(required) *

Name of MD/CEO/Prop.(required) *

List of Products *(required) *

Postal Address. (required) *

Pincode*(required) *

Phone / Mobile *(required) *

Fax

Email*(required) *

Website ( if any)

Contact Person*(required) *

Select Your DesignationManagingn DirectorCeoChairmanProprietor

Year of Establishment*(required)

No. of Employees*(required) *

Any Particular Project/Business/Issue/ that your company is currently working on top priority

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