National Alliance of Street Vendor of India

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Membership Form

Before you proceed for filling up Membership Registration Form, We would like to request you to go through the details of our Membership Policy & Membership Process

Name of the Organization *

Name of Primary Contact Person *

Name of Secondary contact person

Address

	Postal Address	Alternate Postal Address
Name *
House No
Block
Important Landmark*
City/town *
District *
State*
Pin *
Remarks

Telephone/Mobile no (Include STD code also.)

Telephone/Mobile no *
Alternate Telephone/Mobile no

E-mail Address * (if any)

Please ensure a correct email id as you will receive Unique Id on the email id

Year of Formation

Registration No

Member Code :

Are there other Street Vendor organizations in your locality ?

Are they Members of NASVI ?*

Type of Organization :

Number of Vendors :

Male*	Female*	Total*

Membership Fee Detail Amount

Mode of Payment

Other details (Such as DD/Cheque or transaction no.)

Geographical Coverage of your organisation’s work with street vendors

State	District	Block	Locality	Street	Members

(Enter only Numerical Value in above Fields)

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