TEA EXPORTERS ASSOCIATION

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Ceylon Chamber of Commerce, 1 Floor, No. 50, Navam Mawatha, Colombo 2.
Email: admin@teasrilanka.org

APPLICATION FOR AFFILIATE MEMBERSHIP

THE FOLLOWING PARTICULARS ARE FURNISHED REGARDING OUR ASSOCIATION
(All Cages must be filled)

1. Name of the Company / Firm ………….…………………………………………………………………………………………

2. Address (Head Office) ……………………………………………………………………………………………………

(Factory) ……………………………………………………………………………………………………

3. Name of Contact Person & ……………………………………………………………………………………………………

Designation

4. Telephone Nos. ……………………………………………………………………………………………………

5. Fax ……………………………………………………………………………………………………

6. E-mail ……………………………………………………………………………………………………

7. Cellular No. ……………………………………………………………………………………………………

8. Web-site ……………………………………………………………………………………………………

9. Name of Industry …………………………………………………………………………………………………..

10. Products exported …………………………………………………………………………………………………..

11. Names of Directors/Partners Designation

(1).…..…………………………………………………………… ……………………………………………………….

(2) …………………………………………………….…………. ………………………………………………………..

(3) ……………………………………………………………….. ………………………………………………………..

(4) ……………………………………………………….………. ………………………………………………………..

12. Date of Incorporation/Registration:………………………..

13. Business Registration No. (Copy Required) ………………………………..

14. Year of commencement of Business ……………………………………………………………………………………………

15. Annual Turnover ( Last Three Years) …………………………………………………………………………………

2021 Rs ……………………………… 2022 Rs ……………………………….

2023 Rs ……………………………..
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16. Name of Representative:………………………………..……. 17. No. of Employees :

18. Designation : …………………………………………………..

Total
19. Capital Authorized / Paid up Capital Rs.: ………………………………….. Total No. of Employees
Executives
Clerical
Production/Factory
20. Bankers ……………..……………………………………………………………………………………………………………………..

21. Auditors Certification

We certify that the information submitted in question Nos. 15 & 19 are correct.

Name :
Designation :
Signature :
Rubber Stamp :
Date :

22. Names of other Chambers or Associations of which the applicant is a member

(i) ………………………………………………………………………………………………………………………………….

(ii) ……………………………………………………………….………………………………………………………………….

(iii) ………………………………………………………………….………………………………………………………………..

Proposer's Name …………………………….……………………… Seconder's Name ………………..………………………………………

Company ………….………………………………………………….. Company…………..………………..…..………………………………..

Signature ………….…..…………………………………………. … Signature……..…………..……………………………………………….

The Proposer should be your Banker or a Member of the Tea Exporters Association (TEA) and should also
be seconded by a Member of the Tea Exporters Association. Annual Subscription is payable on or before
June each year

We hereby apply to be enrolled as an affiliate member of the Tea Exporters Association and we agree to abide by
the constitution and Rules of the Chamber from time to time in force.

We enclose Cheque * / Cash for Rs. ………………………….. covering Annual Membership Subscription.

FOR OFFICE USE ONLY -

…………………………………………………
Annual Membership Subscription Rs. 60,000.00
(Signature of Applicant with Rubber Stamp)
Total Rs. 60,000.00
Date :………………………………………… ===============

* To be drawn in favour of "Tea Exporters Association"