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"Great vision without great people is irrelevant." Happy Recruiter’s Day- 9th March 2016

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INDIVIDUAL MEMBERSHIP APPLICATION FORM

( Without Voting Rights )

(The individual applicant should be of min. 18 years of age and should be min. 12th Std. Pass)

Type of Individual: (Please tick any one)

Annual Fee of Rs. 590/- (i:e Rs 500/- + 18% GST)

Annual Fee of Rs. 1,180/- (i:e Rs 1,000/- + 18% GST)

Annual Fee of Rs. 2,360/- (i:e Rs. 2,000/- + 18% GST)

Membership will be valid for a period of 1 (one) year from the date of enrollment.

Chapter of preference (Please tick any one):

1. Details of the Individual:

Full Name :
City :
Pincode :
State :
Mobile Number :
Email / Username for future login :
Password :
Date of Birth :
Marital Status :

2. Current College / Organization Details:

College / Organization Name & Complete Address :
Course & Discipline / Industry & Sector
Year of Passing / Current Role or Designation
Contact Information

3. Address for correspondence / communication:

4. Permanent Address: (Please fill, in case if it is different from correspondence address)

5. Total Work Experience, if any

6. Professional Qualification:

Qualification1 :
Qualification2 :
Qualification3 :

7. How did you come to know about ERA: (Please tick)

8. If referred by Member/Friends/Colleagues:

Name of the Member/Friend/Colleague:

9. In what manner you would prefer to be associated with ERA

10. Member of other Associations / Professional Bodies:

11. Please provide 2 references, who are working professionals : (Optional)

References 1:
References 2: