JRM Form


	APPLICATION FORM FOR ENROLMENT WITH THE NCJD JUTE RAW MATERIAL BANKS (TO BE SUBMITTED TO THE NEAREST JRMB)


	Name of the applicant

	Address of the applicant


	..........................................

	..........................................


	Name of the products manufactured / to be manufactured for which jute raw material is required


	................................


	Specify type of raw materials generally required

	Name of the Org. / NGO / Society / SHG / individuals

	Detailed Address


	................................................

		...............................................

		...............................................

		...............................................

		..................Pin Code..................

		Phone: ................ Fax...............

		E-mail.......................................


	(*Separate form is to be filled up and submitted for each applicant)


	________________________ ( Signature of the applicant )

Applications are accepted subject to scrutiny and upon acceptance a user card will be issued with identity number.

In case of difficulty in obtaining raw material or grievance or any suggestion one may at any point in time contact the Executive Director NCJD through mail or in person as convenient.


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