Corporate Membership Enrollment Form

Member *

Silver
Gold

For Silver membership, One-time payment! Pay Rs. 7,500/- admission fee & Can nominate up to 5 Nominees for lifelong membership OR For Gold membership, One-time payment! Pay Rs. 10,000/- admission fee & Can nominate up to 10 Nominees for lifelong membership

Name (Member-1) *

Designation (Member-1) *

Email (Member-1) *

Name (Member-2)

Designation (Member-2)

Email (Member-2)

Name (Member-3) *

Designation (Member-3)

Email (Member-3)

Name (Member-4)

Designation (Member-4)

Email (Member-4)

Name (Member-5)

Designation (Member-5)

Email (Member-5)

Name (Member-6)

Designation (Member-6)

Email (Member-6)

Name (Member-7)

Designation (Member-7)

Email (Member-7)

Name (Member-8)

Designation (Member-8)

Email (Member-8)

Name (Member-9)

Designation (Member-9)

Email (Member-9)

Name (Member-10)

Designation (Member-10)

Email (Member-10)

Name of the Organisation *

Business / Activity

Organisational Email *

A registration confirmation mail will be sent to this email id post submission

Mode of Payment *

I will deposit the amount in ATA's Kotak Mahindra Bank
I will send Cheque/DD to ATA

Enter the amount *

To remit fees through NEFT : Kindly mention the system generated reference number of the Membership Form in the box meant for "Message for the Reciever" as per details: KOTAK MAHINDRA BANK, 55 WEST AVENUE ROAD PUNJABI BAGH WEST, NEW DELHI - 110026 Beneficiary Name: Air Travellers Association SB a/c no 610010090300 RTGS/NEFT Code - KKB0004615

Enter the Cheque/DD No. *

To send DD/Cheque : Kindly mention the system generated reference number of the Membership Form on the reverse of the DD/Cheque payable to Air Travellers Association and mail to: Air Travellers Association, Post Box No 6804, Punjabi Bagh, New Delhi- 110026

Declaration *

We have read and shall abide by the Regulations of the Society at all times. The above submitted information is true to the best of our knowledge and belief. The decision of the Governing Body towards our membership shall be final and binding.