DETAILS OF APPLICANT COMPANYCompany Name AddressPan GST Regn No. Telephone(s) Fax E-mail Website Applicant Photo Choose File CONTACT DETAILSCOMPANY Head in India (who will represent the company) Designation Direct Phone Mobile Residence Telephone E-mail The above person will be on the PCAIT mailing list for all correndance. In case the company wishes to nominate an alternate contact person , please give below details of that personContact Person's Name Designation Direct Phone Mobile Residence Telephone E-mail Main Activities Dealer/trader in computer peripherals/consumablesAnnual Maintenance, Provider of IT Training,IT related Consultancy , Products & Packages Projects Application Service or other IT related service provider System Integration Venture Capital for ITOther (please specify) OTHER DETAILSYear of Establishment Legal Structure of the Company - Select -Sole proprietorshippartnership firmPrivate LtdPublic LtdSocietyInstitutionNumber of IT Professionals employed as on Date No. of other employees as on Date We have read the Vision and Mission and Objects of PCAIT and agree to abide by all the rules and regulations and policies framed by PCAIT as of now and from time to time.Signature of Authorized SignatoryName Place Designation (Affix company seal) Signature Choose File Date Submit Form
