Lifemembership

NIMA Nashik - Membership Registration

-: IMPORTANT :-

This Service Is For ISM Graduates In Nashik And Peripheri Only
Lifetime Membership Fees : Rs 2600/- ( + Convenience Charges Additional)
You will get payment link on this page after form submission and also in recieved email after form submission.
Your membership will be approved & confirmed by NIMA Nashik Branch after verification of documents provided during this form submission and payment status. You will receive email after your membership approval
Please Keep Ready
- Passport Photo (30-300KB) jpg or png Only
- Council Regi Photo (100-500 KB) jpg or png Only
- Degree Certificate Photo (100-500 KB) jpg or png Only
- In Case of Change of Name, Marriage Certificate / Relevant Proof Photo (100-500 KB) jpg or png Only
to upload during this form submission. Click Here To Resize Your Images Now

Membership Form

Fields with * are mandatory.

Name *

Salutation

Surname

First Name

Father/Husband Name

Email *

Do Not Press BACK Button on mobile to check gmail /rediffmail account for OTP. Instead use Home button and then go to gmail / rediffmail app. And then come back here to enter OTP

Mobile *

Registering As *

Address - Residence *

City *

State *

Gender *

Blood Group *

Marital Status *

Is Name Changed ? * (After Marriage)

Marriage Certificate / Proof of Change In Name Document Image *

Upload

Min : 100 KB / Max 500 KB, jpg / jpeg / png only

Birthdate *

Qualification *

Council Registration Number *

Registration Valid Upto *

Institute Currently You Are Working With * ^# Institute name not available in list ? whatsapp on +91 94204 62065

Designation *

Passport Size Photo *

Upload

Min : 30 KB / Max 300 KB , jpg / jpeg / png only

Council Registration Certificate Image *

Upload

Min : 100 KB / Max 500 KB, jpg / jpeg / png only

Degree Certificate Image *

Upload

Min : 100 KB / Max 500 KB, jpg / jpeg / png only

Verification Code *

Enter Random Code Generated Above.