REGISTRATION FORM

To avail all the facilities, register NOW! Annual Fee for the NRI Services Package is Rs. 5000/-.

Please fill in the registration form online and mention your prefered mode of payment.

NAME:

OCCUPATION :

CONTACT ADDRESS :

Phone/Fax No. :

EMAIL ADDRESS:

CONTACT ADDRESS IN INDIA :

Phone/Fax No. :

YOUR BANK/BRANCH IN INDIA :

PAYMENT DETAILS :                    Online Payment using Paypal        Demand Draft        Cheque

Demand Draft or Cheque may be drawn in favour of IMEX FOREX SERVICES and sent to the following address:

Imex Forex Services
608, Harikrupa Tower, B/h Gujarat College, Ellisbridge, Ahmedabad - 380006
Please take a print of this registration format and send in along with your cheque or Demand Draft.
Ų      NAME           :

Ų      OCCUPATION     :

Ų      CONTACT ADDRESS:

Ų      PHONE/FAX NO:

Ų        E-MAIL ID:

Ų      CONTACT ADD.IN INDIA:

Ų      PHONE/FAX NO:

Ų      YOUR BANK/BRANCH IN INDIA:

Ų      PAYMENT DETAILS CHEQUE/DRAFTS NO:_____________DT______

FAVOURING ImexForex Services for Rs.5000/-

SIGNATURE    DATE________