FEDERATION OF INDIAN WOMEN ENTREPRENEURS
FIWE INDIVIDUAL MEMBERSHIP APPLICATION FORM
PERSONAL DETAILS:
Name:
    Address:
City: State: Country:
           Pin code:
           Tel: Fax:
           Email:
Company Name: Company’s Website:
           Company Address:
           Tel:
           Company’s Mission Statement:
           Your Current Position in the Company:
           Is your organization Non-Profit? Yes No
           Preferred mailing address: Home Company
           Describe your business/Area of Expertise along with achievements
            till date: Maximum 150 words. (In a separate word sheet)
           How did you hear about FIWE?
           What made you think to become a FIWE member/Reason to
           become a FIWE member?
          What value you can add to FIWE:
           Being an active member which of the following committee you would like to serve voluntarily-
           Projects            Annual Meetings and Conferences
           Membership Development            Resource Development
           Technology            Marketing &Communication
           Programs
           Entrepreneurship Awareness
           Business Counseling
           Microenterprises
           Women on board initiative
           Generation-X program
           Training
           Mention any awards or special recognitions you have received:
           Membership Dues: (Yearly)
  • Annual Basic Membership Rs.2500.00 plus a one-time registration fee Rs.1000.00
           Mode of Payment:
           Cheque
           Credit Card
           In case of Credit Card please provide below mentioned details:
           Type of card
           Bank Name
           Card No.
           Expiry Date
           Pan no.
Please attach a letter of payment through credit card with your signature.
           Signature & Name of the authorized Signatory:
           Date:            Place:
F- 321 A, 1st Floor, Lado Sarai Village, Opp. Mother Diary, New Delhi – 110030
Ph-011-26850395, Telefax-011-26868531
Email: fiweglobal@gmail.com ,Web site : www.fiwe.org