IM_Reg - Bharat Dietetic Association

+91 77668 52275 info@bdaorg.com

INSTITUTIONAL MEMBERSHIP

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To
The Honorary General Secretary,
Bharat Diet Association of India (BDA)

Dear Sir,
I wish to become a Institutional Membership (IM) of the Association and if selected, I agree to abide by the rules and regulations of the Association. I hereby declare that the information provided by me is correct and if found incorrect my membership may be forfeited.

Personal Details of Director/Proprietor

Salutation:	{radio-1}
First Name:	{name-1}	Last Name:	{name-2}
Mobile	{phone-1}
Gender	{radio-2}	Pan Number	{text-1}
Email	{email-1}	Address	{address-1-street_address}, {address-1-city}, {address-1-state}, {address-1-zip},
Aadher Number:	{text-1}	Whatsapp Number.:	{phone-2}
Website	{url-1}

Company/Institutional Details

Name of Institution	{name-3}
CIN/Registration	{text-2}
Head Office Address	{address-2-street_address}, {address-2-city}, {address-2-state}, {address-2-zip}, {address-2-country}
Nature of Work	{text-5}
Website	{url-1}
Phone Number	{phone-3}
Email-Id	{email-2}
Pan Card Number	{text-4}
GST Number	{text-6}

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Recognition

Slide 1

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Regd. Address

183 MIG, Kankarbagh, Lohia Nagar
Patna

Phone

+91 7766852275

Email Address

info@bdaorg.com

Business Hours

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