Silver Membership
Rs.10000/-
Gold Membership
Rs.20000/-
Patron Membership
Rs.50000/-

 

The Executive Board
India Renal Foundation
Ahmedabad

Dear Sirs,

We wish to become Silver/Gold/Patron member of India Renal Foundation. We have gone through the details of the membership and agree to abide by them.

We send herewith the below mentioned amount by cheque / cash being Silver / Gold / Patron membership subsciption.

We agree that the Executive Committee's decision on our membership request shall be final and binding on me. We give below the required particulars for the consideration of the committee.

 
Amount
Name*
Address*


City*
Phone
Mobile*
Email
Industry
Products
Fields of Interest
Country*
 

* Required

Please name all your payments to
India Renal Foundation payable at Ahmedabad, India.
60-61, A Wing, Nobles, Opp. Nehru bridge, Ashram Road, Ahmedabad 380 009, India.
Phone : +91-79-658 4251  Fax : +91-79-658 7042
Email : irf@indiarenalfoundation.org   www.indiarenalfoundation.org