PERSONAL DETAILS

FULL NAME:

ADDRESS:

CONTACT NO.

HOME:

OFFICE:

MOBILE:

EMAIL:

DATE:

CATEGORY 1B: ASSOCIATE MEMBER - WOMEN IN BUSINESS

Entrepreneur with a business either registered or a start - up,
investment less that Rs 100,000 and less than 5 employees.

POSITION:
ProprietorPartnerDirectorOther

If Other, please describe:

NATURE OF PRODUCTS/SERVICES::

TURNOVER (FOR LAST FINANCIAL YEAR):

NO. OF EMPLOYEES:

(PLEASE ATTACH YOUR CV)

Proposer

Seconder