M.P.HOUSING BOARD:BHOPAL. REGISTRATION FORM FOR THE EMPANELMENT OF ARCHITECT/PLANNER IN M.P.HOUSING BOARD REGISTRATION FORM - Revised or New CATEGORY PHOTOGRAPH 1. Name of Architect/Planner/Firm ____________________________ 2. Address (With telephone) ___________________________ Mobile_____________ Fax________________ City____________Pin code______________ E-mail_________ 3. Qualification : _____________________________ (in case of firm,names and qualification of main partners be mentioned) 4. Registration: 1. Firm Registration No. _____________________________ 2. Council of Architecture _____________________________ 3. Indian Institute of Architect _____________________________ 4. Indian Institute of Town Planners________________________ 5. Any others ___________________________ 5. Experience ________________(Years) (Individual/Firm) (List of works done with cost to be attached in a separate sheet with photographs of the projects completed) In case of projects done for M.P.Housing Board, please give name, please give name,place and year with cost of project and fees charged. 7. Permanent Account Number of Income Tax:_______________ 8. Any other information:- (May like to attach Firm write up/Profile/staff/C.V. with photographs etc.) 9. I/We desired to be empanelled by the M.P.Housing Board and are desirous of undertaking suitable projects for the Board. I/We certify that the above information is correct to the best of my/our knowledge. Place: Date (Signature) (Name & Designation)