ENROLLMENT FORM FOR PDI 2012
*Company
*Address
	*PIN
*City	*State
*Contact Person
Logo
	(Select file (psd,cdr,jpg,gif,pdf) upto 2MB size)
*Designation
*Phone
Fax	Mobile
*Email
Website
*First Name                                     Middle Name                               *Last Name
Head of the Org.
*Designation
IPA Membership No.
	All fields marked * are mandatory.

TICK THE APPLICABLE CATEGORY
Air Ventilation Systems Manufacturer	Pipes & Fittings Manufacturer      Material :
Agriculture / Garden / Irrigation Products Manufacturer	Pump Manufacturer
Bathroom Fittings & Accessories Manufacturer	Tools Manufacturer
Sanitaryware	Valves Manufacturer
Boiler Manufacturer	Fountains Manufacturer
Fire Fighting Product Manufacturer	Swimming Pool Products Manufacturer
Flooring & Cladding Materials Manufacturer	Water Heating System Manufacturer
Hospital / Laboratory Equipment Manufacturer	Water Storage System Manufacturer
Insulation Materials Manufacturer	Water Proofing Chemicals Manufacturer
Kitchen Fittings & Accessories Manufacturer	Water Treatment / Purification Systems Manufacturer
Distributor / Dealer / Trader           Products :
Plumbing Contractor                         Services :
Plumbing Consultant                         Services :
MEP Consultant/PMC                        Services :
Architect / Interior Designer	Builder / Real Estate Developer
Government Organisation	Educational Institute
Others :
Notes :  - Use CAPITAL Letters to fill in the information.             - Logo will be published only for those entries for which payment has been received.                 - Logo will published in single color only and hence, it must be sent in single color format only.                 - Logos may be sent in minimum 300 dpi resolution in JPEG/TIFF formats.