Watermark

NH-18, Bijayramchandrapur, Ward no-21, Po-Bhanjpur, Baripada, Dist-Mayurbhanj, Odisha, India
Email: mayurbhanjchamber@gmail.com  |  Phone: +91 9437238322
🏢 Company / Firm / Organization Name
Membership ID: ________
[To be filled by the Office of MAYCCI]
 
👤 Personal Details
Name  
Designation  
Contact  
Email  
Address  
🏭 Office Details
Office Name  
Office Phone  
Website  
GST No  
Office Address  
Year of Establishment  
No. of Employees  
Scale (Large / Medium / Small)  
Sector  
Investment (Rs.)  
Turnover (Year – Amount)  
Export (Year – Amount)  
Import (Year – Amount)  
Nature of Business  
Products  
Watermark
MAYCCI – Membership Form
Executive and Membership Details
👔 CEO / Proprietor Details
Name  
Phone  
Mobile  
Email  
Correspondence Address  
Factory Address  
📋 Membership Category

Please tick (✔️) the checkbox in the last column to select your applicable membership category.

Category Name Category Code Criteria Registration Fee (₹) Annual Subscription (₹) Validity (Days) Select ✔️
Aspiring Entrepreneur ASPENT-1 Individuals planning to start a business, Freelancers, gig workers, home-based entrepreneurs FREE N/A 365
Associate / Supporter AS NGOs, SHGs, incubators, development agencies 1000.00 2000.00 365
Corporate / Institutional CI-1 Turnover upto Rs. 100 Crore 5000.00 2500.00 365
Honorary HON Eminent personalities, Policy makers, Social & economic contributors FREE N/A 365
Mentor / Investor MI Angel investors, Industry veterans, Startup mentors 1000.00 2000.00 365
MSME MSME-1 MSMEs, shop owners, service providers 2000.00 1000.00 365
Professional / Individual PI-1 Consultants, CAs, lawyers, designers, IT professionals 1000.00 1000.00 365
Startup S-1 Startup, recognized by Startup India or Startup Odisha 500.00 1000.00 365
Student Innovator STUD-1 College / university students/ entrepreneurship cell members/ Early-stage idea holders FREE N/A 365
Student-Led Startup S-2 Startups founded or co-founded by students FREE N/A 365
Watermark
MAYCCI – Membership Form
Rules & Regulations
📜 Terms & Conditions

1. Eligibility

  • The applicant must be an individual, firm, company, or organization engaged in lawful business or professional activity.

  • All information provided in the registration form must be true, complete, and accurate.

2. Approval of Membership

  • Submission of the registration form does not guarantee membership.

  • The Chamber reserves the exclusive right to accept or reject any application without providing reasons.

  • Membership becomes active only after verification of documents and successful payment of applicable fees.

3. Membership Fees

  • All membership fees, annual subscriptions, and renewal charges must be paid within the prescribed time.

  • Fees once paid are non-refundable, except in special cases at the discretion of the Chamber.

4. Member Responsibilities

  • Members must adhere to the rules, policies, and code of conduct set by the Chamber.

  • Members must not engage in activities that harm the reputation or functioning of the Chamber.

  • Any change in contact details or business information must be promptly updated with the Chamber.

5. Use of Chamber Services

  • Access to Chamber services, events, and benefits is limited to active members only.

  • Misuse of membership privileges may lead to suspension or termination.

6. Data Usage & Privacy

  • By registering, the member consents to the Chamber storing and using their details for communication, verification, and official purposes.

  • Personal data will not be shared with third parties except as required by law or for Chamber operations.

7. Termination of Membership

  • Membership may be terminated due to violation of rules, non-payment of fees, or submission of false information.

  • Terminated or resigned members are not entitled to any refund of fees.

8. Limitation of Liability

  • The Chamber is not responsible for any financial or business loss incurred by members due to decisions or suggestions provided by the Chamber.

  • All events and services are offered on a best-effort basis.

9. Amendments

  • The Chamber reserves the right to modify, add, or remove any terms and conditions at any time.

  • Updated terms will be communicated to members through email/website.

Applicant's Signature with Seal
Watermark
MAYCCI – Membership Form
Documentation, Declaration & Signatures
📎 Documents Submitted
Check Document Type
PAN Card
Aadhaar Card
GST Certificate
Balance Sheet
Others
✍️ Declaration
I hereby declare that the information provided above are true to the best of my knowledge and my membership in the Mayurbhanj Chamber of Commerce & Industry may become invalid if any discrepancies are found in the above information. I also do hereby agree with all the Terms & Conditions set by the Chamber and will give my full support for the betterment of the Chamber as well as the district of Mayurbhanj.
Authorised Signature with Seal of the Member
Date and Place
Authorised Signature with Seal of MAYCCI
Date and Place