NIMA Gujarat - Membership Registration

IMPORTANT^**

This Service Is For ISM Graduates In Gujarat State Only
Lifetime Membership Fees : Rs 2500/-
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 Gujarat State 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
to upload during this form submission. Click Here To Resize Your Images Now

Fields with * are mandatory.

Name *

Salutation

Surname

First Name

Father/Husband Name

Email *

Confirm Email *

Mobile *

Registering As *

Address - Residence *

City *

State *

Gender *

Blood Group *

Marital Status *

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 * Min : 30 KB / Max 300 KB , JPG/PNG only

Council Registration Certificate Image * Min : 100 KB / Max 500 KB, JPG/PNG only

Degree Certificate Image * Min : 100 KB / Max 500 KB, JPG/PNG only

Verification Code *

Enter Random Code Generated Above.