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CONFEDERATION OF I.T ASSOCIATIONS

Regd No : 1029/2007

No.27, Vallalar Street, 2nd Floor, Pondycherry-11.

Please enter Name. Name of the Member*

User Email*

Password*

Confirm Password*

Personal details

DOB (Certificate)

Same DOB as certificate

DOB

Wedding Anniversary

Blood Group

Aadhaar Number*

Select Profile Image

Address details

Home Address

Address Line 1*

Address Line 2

City*

Pincode*

Office Address

Address Line 1*

Address Line 2

City*

Pincode*

Contact details

Phone Number

Phone STD

Mobile Number*

Alternative Mobile Number

Nominee Details

Name

DOB

Relationship

Business details

Name of the Association*

Office Email*

GSTIN Number*

Pan Number*

Business Since*

Name of the Company*

Facebook Link

Twitter Link

Instagram Link

Business Category

Distributor

Volume Partner

Reseller

Service Provider

Software

CCTV Dealer

UPS Dealer

Office Automation

Others

If any asa Posting in Local Association If yes mention Details(only Office Bearer)

Association

Designation

Period

If any Posting in CONFED-ITA If yes mention Details(Office Bearer/EC Member)

Association

Designation

Period

Partner / director Details

Partner / Director Name

Designation

DOB(Certificate)

DOW

Blood Group

Aadhaar Number

Mobile Number

Family Members Details

Name of the Family Members

Relationship

DOB(Certificate)

Age

Nominees

Blood Group

Aadhaar Number

Mobile Number

Others