ALL INDIA ASSOCIATION OF COAL EXECUTIVES
AIACE - Members Form (For Any query, Call - 9907434051)
Email address *
Type of Membership Desired *
EIS Number *
(Employee No.)
Your answer
Salutations *
Name of Executive *
In Capital Letters only
Your answer
Gender *
Name of Dependent Member
(Only for Dependent Member)
Your answer
Father's/Husband's Name *
In Capital Letters only
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Date of Joining in Company *
(Appointment Date in company)
MM
/
DD
/
YYYY
Date of Joining in Executive Cadre *
(Will be same as Date of Joining for those who directly joined as executive )
MM
/
DD
/
YYYY
Date of Retirement/VRS/Resignation
(Only for Advisory Members)
MM
/
DD
/
YYYY
Marital Status *
Grade *
Designation *
DISCIPLINE *
Company *
Name of Area *
In Capital Letters only
Your answer
Place of Posting/Retirement *
Unit/Project Name, if posted at Area Type Area Name Only
Your answer
Residential Address *
Your answer
State *
District *
Your answer
PIN Code *
Your answer
Educational Qualification *
In Capital Letters only
Your answer
Mobile Number 1 *
Your answer
Mobile Number 2
Your answer
CMPF No. *
Your answer
PPO No.
(In case of Advisory Members)
Your answer
Social Media Links - Facebook
Optional
Your answer
Social Media Links - Twitter
Optional
Your answer
Response Option *
Preferred Communication Mode
Required
A copy of your responses will be emailed to the address you provided.
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