Corporate Member(s)

     MEMBERSHIP FORM FOR CORPORATE MEMBER(S)

                                                                                           Form No. TATA/002/2015

1. Name of Organization/Company: …………………………………………………………………………
2. Registration No: …………………………………………..
3. Physical Address: ………………………………………..
4. TIN No: …………………………………………………..
5. Services/Products offered: …………………………………………….
6. Name of Chairperson: …………………………………………..
7. Name of Secretary: ……………………………………………….
8. Name of Treasurer: ………………………………………………..
9. Mobile No: ……………………………… Email address: ……………………………………….
10. Declaration: We the undersigned declare to the best of my knowledge that the                          information provided is indeed correct.
11. Signature: …………………………..
12. Date: ……………………..

                                        P.O. BOX 2259 SAMORA AVENUE DAR ES SALAAM TANZANIA

Website: www.tata.or.tz                                                                         Email: info@tata.or.tz

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