Automobile Association of Upper India
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Online Membership (For Individual/Companies)
(Fields marked with a * are mandatory to fill)
Name of Individuals/Company
Date
Type of membership required
Residential Address
Telephone No. Residence)
 
Office Address
 
Telephone No. (Office)
 
Fax
 
E-mail
 
Profession
 
Blood Group
Post Held
 
Vehicle Details
No Type of Vehicle  Make Manufacturer Registration 
No		 Insurance
 Company
1
 Driving License Detail
No License No. Date of Issue Valid Up to Issued By Remarks
1
 Insurance Detail
No Policy No. Policy Issue Date Policy Expire date Insurance Company value insured
1

I/We Agree to be bound by all rules, regulations and by- laws of the Association, if elected

On Submission of this online form, kindly send a demand draft/Cheque in favour of "The Automobile Association of Upper India", New Delhi for the requisite membership fees. (Please check the membership fees table) Do write your name and Telephone number on reverse of the DD/Cheque and send the same under covering letter at the following address:-

Automobile Association of Upper India
C-8, Qutab Institutional Area,
New Delhi-110 016.