STRATEGIC MANAGEMENT FORUM

INSTITUTIONAL/ PROFESSIONAL INDIVIDUAL(PI) MEMBERSHIP

 

1. Category Applied for

: Patron ¸

 

PI Life Member ¸

 

PI Annual Member ¸

2. Name (in capital letter only)

:_________________________________________________________

3. Father’s/Husband’s Name (PI  only

:_________________________________________________________

4. Organization: Name & Address

:_________________________________________________________

 

__________________________________________________________

 

__________________________________________________________

 

__________________________________________________________

5. Home Address (PI only)

:_________________________________________________________

 

__________________________________________________________

 

__________________________________________________________

 

__________________________________________________________

6. Telephone

:Off: _____________________ Res: ____________________________

Fax :_____________________Email____________________________

7. Date of Birth (PI)/   Incorporation (for Institutional Members)

: Day_____________ Month ________________Year _____________

8. Age as on Date

:Years_____________________________________________________

9. Preferred Mailing Address

Home Office

10. Experience (PI) in academics/

Executive cadres as on date

(No. of years)

 

:________________________________________________________

11. Professional Experience (PI)

 

From

To

Designation

Organization and Job Details

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

12. Membership of other Professional Bodies

________________________________________________

13. Declaration of the applicant

I declare that the statements made throughout this application are correct to the best of my knowledge and belief and that I agree to be governed by the bye-laws of the SMF as they now exist and hereafter if they be altered. I further undertake that I will promote the objectives of the SMF and contribute to the best of my abilities for furthering strategic Management movement in the country. If at any time, I fail to comply with the requirements of the SMF with regard to the membership, I hereby undertake to return the Certificate of Membership and forfeit the privileges associated with this membership. I also undertake to abide by the SMF Code for Professional Managers’ that the Forum may frame from time to time.

 

 

Date: __________________________

Applicant’s Signature _____________________________________

 Payment particulars$ (To be filled by applicant)

Draft No. _____________________________________ Amount Rs. ________________________________

Issuing Bank ___________________________________Date Issue _________________________________

$ Subscription for membership:

  

 

Tick mark only in the numbered boxes provided against the alternative to each question. This is for the purpose of computerized date processing. Please be sure to complete each item.

1. Age as on date

6. Total experience (In years)

25-30

31-35

36-40

41-50

Above 50

3-5

6-10

11-15

16-20

More than 20

2. Sex

7. Professional Skills Acquired

Male

HRD/Personnel

Female

Marketing/Sales

 

Finance

3. Marital Status

Quality Control

Married

Corporate planning

Single

EDP

   

4. Education Qualifications

8. Type of Organisation

Graduate B.Sc/BA/B.Com

Government

Post Graduate M.Ss/M.com/MA/MBE

Public Sector

Engineers BE/B.Tech

Private Sector

ME/M.Tech/MCA

Defence Service

Management Diploma MBA

Bank & Financial Institutions

PHD or equivalent

Medicine

ACS/ICWA/CA other equivalent

Multinationals

Others (specify)

Small Scale Sector

   

5. Natural of Business of your Organization

9. Level at which you are currently working

Manufacturing

Jr. Management

Marketing/Sales

Middle Management

Banking Service

Senior Management

Public Utility Services

Top Management

Consultancy

Others (Specify) ________________________

Defence

 

Others(Specify) ________________________