I/We am/are interested to become a Member of MKB. I/We agree to abide by the Terms and Conditions stated in this Brochure. I/We am/are enclosing * a DD/Cheque No...............dt in favour of Small Industries Information Services Center, for Rs..........payable at Lucknow/Cash Rs..............

Name of The Company
Individual / Institution
Product/Service
Contact Person
GSTIN
Ph.No./Fax No
Designation
Pincode
E-MAIL ID
Address