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Start Exnora Innovators Club in your Neighbourhood / Area Registration Form
Name of the person initiating 'Exnora Innovators Club'*
City*
Work Address
Work Phone
Home Phone*
Mobile Phone
Email ID*
Activities proposed to be taken including the name of the neighbourhood (see web site 'Exnora Innovators Club')
Are you willing to be the convenor of the 'Exnora Innovators Club'* Yes  No
Please mention the list of co-convenors and the members with their contact details.

Kindly register our Exnora Innovators Club and grant us affiliation, Please find enclosed Rs. 1500 towards registration fee (Rs. 500) & annual subscription (Rs. 1000) or equal amount in foreign currency. (Cheques to be drawn in favour of Exnora International for those who want to start in India and Exnora International Foundation for those who want to start outside India).

*Proposed Club name should correspond geographically with area Eg: Exnora Innovators Club, Mylapore/Bandra/Kalighat/Chandini Chowk/ Jai Nagar / Kawdiar / Himayat Nagar.

For any further support, Please contact us at:

Exnora International
#20, Giriappa Road, T Nagar,
Chennai 600017, Tamilnadu, India.
Phone 91 44 2815 3376 / 91 44 2475 9477, 2475 5478 USA No.703 579 8142

Tele Fax 91 44 4219 3596
E-mail mbnirmal@yahoo.com, mbnirmal@gmail.com & exnoraindia@hotmail.com

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