Register - PEATA India - Practicing Engineers, Architects, and Town Planners Association (INDIA)

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APPLICATION FORM FOR LIFE MEMBERSHIP

(Note : Please read instructions overleaf carefully before filling up the form)

To,
The President,

Practising Engineers Architects and Town Planners Association (India)
Unit No. A-103, 1st Floor, New Udyog Mandir No. 2,
Behind Johnson & Johnson, 7-C, Mogul Lane, Mahim (W), Mumbai - 400 016.

I the undersigned, would like to get enrolled as Life Member of PEATA (I). I promise, if enrolled, will abide by and observe the provisions of the constitution in force and that I will promote the objects of the Association as far as may be in my power. I enclose herewith necessary documents listed below along with a cash/cheque for Rs. /- in favour of PEATA (I)
towards following :-

PEATA Membership No.

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First Name

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Last Name

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Father/Husband's Name

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Name of Establishment

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Classification

Builder/Developer

Contractor

Manufacturer

Real Estate Consultant

Interior Decorator

Individual

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Designation

Proprietor

Partner

Associate

Director

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Office address

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Residential address

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Phone No

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Whatsapp No.

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Email Address

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Password

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Strength: Very Weak

Date Of Birth

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Age

* In years

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Blood Group

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PAN No

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GSTIN Number

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Technical Qualifications

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Number of years in Practice as Licenced Surveyor/Architect/Structural Engineer/Town Planner/Regd. Valuer/Landscape Architect/Interior Designer or any other related profession

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Years

Special field of Interest/Expertise

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Membership of any other Professional Societies / Association / Institution with Registration Nos.

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Registration Details :

Surveyor / Structural Engineer's License, issued by Municipal Corporation of Gr. Mumbai OR any other please specify

License No.

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Date

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Surveyor / Structural Engineer's License

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Registration Certificate issued by, Council of Architecture - New Delhi.

Registration No.

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Date

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Registration Certificate

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Note : Attach attested copy of up to date valid, Surveyor's / Structural Engineer's License, issued by M.C.G.M. or any other / or Registration Certificate issued by the Council of Architecture - New Delhi.

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